Natalie Pearson

An assessment of self-reported physical activity instruments in young people for population surveillance: Project ALPHA

BackgroundThe assessment of physical activity is an essential part of understanding patterns and influences of behaviour, designing interventions, and undertaking population surveillance and monitoring, but it is particularly problematic when using self-report instruments with young people. This study reviewed available self-report physical activity instruments developed for use with children and adolescents to assess their suitability and feasibility for use in population surveillance systems, particularly in Europe.MethodsSystematic searches and review, supplemented by expert panel assessment.ResultsPapers (n = 437) were assessed as potentially relevant; 89 physical activity measures were identified with 20 activity-based measures receiving detailed assessment. Three received support from the majority of the expert group: Physical Activity Questionnaire for Children/Adolescents (PAQ-C/PAQ-A), Youth Risk Behaviour Surveillance Survey (YRBS), and the Teen Health Survey.ConclusionsPopulation surveillance of youth physical activity is strongly recommended and those involved in developing and undertaking this task should consider the three identified shortlisted instruments and evaluate their appropriateness for application within their national context. Further development and testing of measures suitable for population surveillance with young people is required.

Sedentary behavior and dietary intake in children, adolescents and adults: A systematic review.

CONTEXT Sedentary behavior is implicated in youth and adult overweight and obesity. However, the relationship between sedentary behavior and weight status is often small or inconsistent, with few studies controlling for confounding factors such as diet and physical activity. Diet has been hypothesized to covary with some sedentary behaviors. It is opportune, therefore, to review whether dietary intake is associated with sedentary behavior in young people and adults. This may allow for better interpretation of the diversity of findings concerning sedentary behavior and weight status. EVIDENCE ACQUISITION Published English-language studies were located from computerized and manual searches in early 2010. Included studies were observational studies assessing an association between at least one sedentary behavior and at least one aspect of dietary intake in children (aged <11 years), adolescents (aged 12-18 years), or adults (aged >18 years). EVIDENCE SYNTHESIS Fifty-three studies, totaling 111 independent samples, were eligible for this review. Sedentary behavior in children (n=19, independent samples=24), adolescents (n=26, independent samples=72), and adults (n=11, independent samples=14) appears to be clearly associated with elements of a less healthy diet including lower fruit and vegetable consumption; higher consumption of energy-dense snacks, drinks, and fast foods; and higher total energy intake. Strengths of association were mainly in the small-to-moderate range. CONCLUSIONS The association drawn mainly from cross-sectional studies is that sedentary behavior, usually assessed as screen time and predominantly TV viewing, is associated with unhealthy dietary behaviors in children, adolescents, and adults. Interventions need to be developed that target reductions in sedentary time to test whether diet also changes.

Tracking of sedentary behaviours of young people: a systematic review.

OBJECTIVE To review the empirical evidence concerning the strength of tracking of sedentary behaviours from childhood and adolescence. METHODS Published English language studies were located from computerised and manual searches in 2009. Included studies were prospective, longitudinal studies with at least one sedentary behaviour for at least two time-points, with tracking coefficients reported, and included children (aged 3-11 years) and adolescents (12-18 years) at baseline. RESULTS Based on data from 21 independent samples, tracking coefficients (r) ranged from 0.08 (over 16 years) to 0.73 (over 2 years) for TV viewing, from 0.18 (boys over 3 years) to 0.52 (over 2 years) for electronic game/computer use, from 0.16 (girls over 4 years) to 0.65 (boys over 2 years) for total screen time, and from -0.15 (boys over 2 years) to 0.48 (over 1 year) for total sedentary time. Study follow-up periods ranged from 1 to up to 27 years, and tracking coefficients tended to be higher with shorter follow-ups. CONCLUSIONS Sedentary behaviours track at moderate levels from childhood or adolescence. Data suggest that sedentary behaviours may form the foundation for such behaviours in the future and some may track slightly better than physical activity.

Review and special articleSedentary Behavior and Dietary Intake in Children, Adolescents, and Adults: A Systematic Review

CONTEXT Sedentary behavior is implicated in youth and adult overweight and obesity. However, the relationship between sedentary behavior and weight status is often small or inconsistent, with few studies controlling for confounding factors such as diet and physical activity. Diet has been hypothesized to covary with some sedentary behaviors. It is opportune, therefore, to review whether dietary intake is associated with sedentary behavior in young people and adults. This may allow for better interpretation of the diversity of findings concerning sedentary behavior and weight status. EVIDENCE ACQUISITION Published English-language studies were located from computerized and manual searches in early 2010. Included studies were observational studies assessing an association between at least one sedentary behavior and at least one aspect of dietary intake in children (aged <11 years), adolescents (aged 12-18 years), or adults (aged >18 years). EVIDENCE SYNTHESIS Fifty-three studies, totaling 111 independent samples, were eligible for this review. Sedentary behavior in children (n=19, independent samples=24), adolescents (n=26, independent samples=72), and adults (n=11, independent samples=14) appears to be clearly associated with elements of a less healthy diet including lower fruit and vegetable consumption; higher consumption of energy-dense snacks, drinks, and fast foods; and higher total energy intake. Strengths of association were mainly in the small-to-moderate range. CONCLUSIONS The association drawn mainly from cross-sectional studies is that sedentary behavior, usually assessed as screen time and predominantly TV viewing, is associated with unhealthy dietary behaviors in children, adolescents, and adults. Interventions need to be developed that target reductions in sedentary time to test whether diet also changes.

Family correlates of breakfast consumption among children and adolescents: A systematic review

Regular breakfast consumption can have a multitude of positive health benefits, yet young people are more likely to skip breakfast than any other meal. Given the evidence that dietary behaviours established in childhood and adolescence track into adulthood along with evidence that breakfast skipping increases with age, identifying correlates of childrens and adolescents breakfast behaviours is imperative. The family environment is an important influence on the dietary behaviours of young people, and therefore we systematically reviewed the literature on family correlates of children and adolescents breakfast consumption. From the 24 papers reviewed, 6 studied children and 19 studied adolescents. Few studies have examined the same specific family correlates of breakfast consumption, limiting the possibilities of drawing strong or consistent conclusions. Research in this area is relatively new and this review has identified areas for further investigation. Parental breakfast eating and living in two-parent families were the correlates supported by the greatest amount of evidence in association with adolescents breakfast consumption. The results suggest that parents should be encouraged to be positive role models to their children by targeting their own dietary behaviours and that family structure should be considered when designing programmes to promote healthy breakfast behaviours.

Associations between sedentary behaviour and physical activity in children and adolescents: a meta-analysis

Physical activity and sedentary behaviour are associated with metabolic and mental health during childhood and adolescence. Understanding the inter‐relationships between these behaviours will help to inform intervention design. This systematic review and meta‐analysis synthesized evidence from observational studies describing the association between sedentary behaviour and physical activity in young people (<18 years). English‐language publications up to August 2013 were located through electronic and manual searches. Included studies presented statistical associations between at least one measure of sedentary behaviour and one measure of physical activity. One hundred sixty‐three papers were included in the meta‐analysis, from which data on 254 independent samples was extracted. In the summary meta‐analytic model (k = 230), a small, but significant, negative association between sedentary behaviour and physical activity was observed (r = −0.108, 95% confidence interval [CI] = −0.128, −0.087). In moderator analyses, studies that recruited smaller samples (n < 100, r = −0.193, 95% CI = −0.276, −0.109) employed objective methods of measurement (objectively measured physical activity; r = −0.233, 95% CI = −0.330, −0.137) or were assessed to be of higher methodological quality (r = −0.176, 95% CI = −0.215, −0.138) reported stronger associations, although effect sizes remained small. The association between sedentary behaviour and physical activity in young people is negative, but small, suggesting that these behaviours do not directly displace one another.

Parenting styles, family structure and adolescent dietary behaviour

OBJECTIVE To examine associations between parenting styles, family structure and aspects of adolescent dietary behaviour. DESIGN Cross-sectional study. SETTING Secondary schools in the East Midlands, UK. SUBJECTS Adolescents aged 12-16 years (n 328, 57 % boys) completed an FFQ assessing their consumption of fruit, vegetables, unhealthy snacks and breakfast. Adolescents provided information on parental and sibling status and completed a seventeen-item instrument measuring the general parenting style dimensions of involvement and strictness, from which four styles were derived: indulgent, neglectful, authoritarian, authoritative. RESULTS After controlling for adolescent gender and age, analysis of covariance revealed no significant interactions between parenting style and family structure variables for any of the dietary behaviours assessed. Significant main effects for family structure were observed only for breakfast consumption, with adolescents from dual-parent families (P < 0.01) and those with no brothers (P < 0.05) eating breakfast on more days per week than those from single-parent families and those with one or more brother, respectively. Significant main effects for parenting style were observed for all dietary behaviours apart from vegetable consumption. Adolescents who described their parents as authoritative ate more fruit per day, fewer unhealthy snacks per day, and ate breakfast on more days per week than those who described their parents as neglectful. CONCLUSIONS The positive associations between authoritative parenting style and adolescent dietary behaviour transcend family structure. Future research should be food-specific and assess the efficacy of strategies promoting the central attributes of an authoritative parenting style on the dietary behaviours of adolescents from a variety of family structures.

Patterns of adolescent physical activity and dietary behaviours.

BackgroundThe potential synergistic effects of multiple dietary and physical activity behaviours on the risk of chronic conditions and health outcomes is a key issue for public health. This study examined the prevalence and clustering patterns of multiple health behaviours among a sample of adolescents in the UK.MethodsCross-sectional survey of 176 adolescents aged 12–16 years (49% boys). Adolescents wore accelerometers for seven days and completed a questionnaire assessing fruit, vegetable, and breakfast consumption. The prevalence of adolescents meeting the physical activity (≥ 60 minutes moderate-to-vigorous physical activity/day), fruit and vegetable (≥ 5 portions of FV per day) and breakfast recommendations (eating breakfast on ≥ 5 days per week), and clustering patterns of these health behaviours are described.ResultsBoys were more active than girls (p < 0.001) and younger adolescents were more active than older adolescents (p < 0.01). Boys ate breakfast on more days per week than girls (p < 0.01) and older adolescents ate more fruit and vegetables than younger adolescents (p < 0.01). Almost 54% of adolescents had multiple risk behaviours and only 6% achieved all three of the recommendations. Girls had significantly more risk factors than boys (p < 0.01). For adolescents with two risk behaviours, the most prevalent cluster was formed by not meeting the physical activity and fruit and vegetable recommendations.ConclusionMany adolescents fail to meet multiple diet and physical activity recommendations, highlighting that physical activity and dietary behaviours do not occur in isolation. Future research should investigate how best to achieve multiple health behaviour change in adolescent boys and girls.

The relationship between sedentary behaviour and physical activity in adults: a systematic review.

To ascertain, through a systematic review, the associations between sedentary behaviour (SB) and physical activity (PA) among adults aged 18-60years. Studies published in English up to and including June 2013 were located from computerized and manual searches. Studies reporting on at least one measure of SB and an association with one measure of PA were included. 26 studies met the inclusion criteria. Six studies examined associations between SB and PA prospectively, and 20 were cross-sectional. The most commonly assessed subtype of sedentary behaviours were television viewing (11 studies), total sedentary time (10), total sitting time (4), general screen time (3) and occupational sedentary time (2). All studied types of SB were associated with lower levels of PA in adults. Findings of this review suggest inverse associations between SB and PA were weak to moderate. Objective monitoring studies reported larger negative associations between SB and light intensity activity. Current evidence, though limited, supports the notion that sedentary behaviour displaces light intensity activity.

Interventions designed to reduce sedentary behaviours in young people: a review of reviews

Background Leisure time is increasingly spent in sedentary pursuits such as screen-viewing (eg, television/DVD viewing and computer use), motorised travel, school/work and sitting-based socialising (eg, social media and chatting). Sedentary screen time, particularly TV, appears to play an important role in the aetiology of obesity due to its co-occurrence with other unhealthy behaviours such as snacking on energy-dense foods, low levels of physical activity and inadequate sleep. More information is needed on how to reduce sedentary behaviours. Most interventions have focused on young people and a number of systematic reviews exist on this topic. Objective To synthesise systematic reviews and meta-analyses of interventions aimed at decreasing sedentary behaviours among children and adolescents. Methods Papers were located from computerised and manual searches. Included articles were English language systematic reviews or meta-analyses of interventions aiming at reducing sedentary behaviour in children (<11 years) and adolescents (12–18 years). Results Ten papers met the inclusion criteria and were analysed. All reviews concluded some level of effectiveness in reducing time spent in sedentary behaviour. When an effect size was reported, there was a small but significant reduction in sedentary time (highest effect size=−0.29; CI −0.35 to −0.22). Moderator analyses showed a trend favouring interventions with children younger than 6 years. Effective strategies include the involvement of family, behavioural interventions and electronic TV monitoring devices. Conclusions Results from systematic reviews and meta-analyses show that interventions to reduce childrens sedentary behaviour have a small but significant effect. Future research should expand these findings examining interventions targeting different types of sedentary behaviours and the effectiveness of specific behaviour change techniques across different contexts and settings.