Sharon E. Taverno Ross

Maternal Inactivity: 45-Year Trends in Mothers' Use of Time

OBJECTIVE To examine 45-year trends in time use and physical activity energy expenditure (PAEE) in a nationally representative sample of US mothers. PARTICIPANTS AND METHODS We quantified time allocation to physical activity (PA), sedentary behaviors (SED), and PAEE from 1965 to 2010 in mothers with older children (MOC) (>5 to ≤18 years) and mothers with younger children (MYC) (≤5 years). Physical activity was the sum of time allocated to housework, child care, laundry, food preparation, postmeal cleanup, and exercise. Sedentary behavior was the sum of time spent in a vehicle and using screen-based media. Physical activity energy expenditure was calculated using body weights from national surveys and metabolic equivalents. RESULTS From 1965 to 2010, the time allocated to PA decreased by 11.1 h/wk (from 32.0 to 20.9 h/wk) in MOC and by 13.9 h/wk (from 43.6 to 29.7 h/wk) in MYC. The time spent in SED increased by 7.0 h/wk in MOC (from 17.7 to 24.7 h/wk) and increased by 5.7 h/wk in MYC (from 17.0 to 22.7 h/wk). Physical activity energy expenditure decreased by 1237.6 kcal/wk (176.8 kcal/d) in MOC (from 5835.3 to 4597.7 kcal/wk), and in MYC, PAEE decreased by 1572.5 kcal/wk (224.6 kcal/d), from 7690.5 to 6118.0 kcal/wk. CONCLUSION There was a significant reallocation of time by mothers from PA (eg, housework) to SED (eg, watching television) between 1965 and 2010. Given the essential role of PA for health and the potential for the intergenerational transmission of obesity and obesogenic behaviors, these results suggest that maternal inactivity may be an important target for the primary prevention of chronic noncommunicable diseases and obesity.

Associations among physical activity, diet quality, and weight status in US adults.

PURPOSE Nearly 70% of adult Americans are overweight or obese, but the associations between physical activity, diet quality, and weight status have not been examined in a representative sample of US adults. The purpose of this study was to examine the associations among moderate-to-vigorous physical activity (MVPA), diet quality, and weight status within and across age groups in US adults. METHODS Participants included 2587 men and 2412 women age 20 to ≥70 yr from the National Health and Nutrition Examination Survey 2003-2004 and 2005-2006. Physical activity was measured by accelerometry. Diet quality was assessed with overall Healthy Eating Index-2005 scores. Measures of weight status, body mass index (BMI), and waist circumference were assessed using standard National Health and Nutrition Examination Survey protocols. RESULTS Across age groups, MVPA was lower in the older age groups for both men and women, whereas diet quality was higher (P < 0.001). BMI and waist circumference were also higher in the older age groups (P < 0.05). Within age groups, MVPA was inversely associated with BMI and waist circumference for men and women in nearly every age group (P < 0.05). Diet quality was inversely associated with the weight status variables only in men age 30-39, 40-49 (BMI only), and 50-59 yr and women age 50-59 yr (P < 0.05). CONCLUSIONS We observed clear age-related trends for measures of weight status, physical activity, and diet quality in US men and women. MVPA was very consistently related to weight status in both genders. The relation between diet quality and weight status was less consistent. These findings provide support for public health efforts to prevent obesity by promoting increased physical activity in adult Americans.

What is really causing the obesity epidemic? A review of reviews in children and adults

ABSTRACT Obesity prevention is a public health priority and intervention strategies have focused primarily on healthy eating and physical activity in children and adults. To date, no review has systematically compiled and synthesised the scientific evidence from published review articles to determine whether there is clear consensus on the causes of obesity. A systematic review of the literature was conducted searching PubMed/Medline for narrative and systematic review articles published between January 1990 and October 2014 that examined the causes of obesity. In total, 12 of 65 articles met the inclusion criteria; 7 reviews focused on adults (1 systematic, 6 narrative) and 5 reviews on children (2 systematic, 3 narrative). The most popular cause of obesity identified in reviews of adult studies was “combined physical activity and diet” (3 of 7 studies), whereas the most popular cause specified in reviews of child studies was deemed “inconclusive” (2 of 5 studies). While a number of reviews have examined the causes of obesity, the methodology and conclusions varied widely, and few were conducted systematically. Currently, no consensus exists across published literature reviews regarding the primary cause of the obesity epidemic, and more research, particularly prospective studies using state-of-the-art measures, is warranted.

Sedentary Behaviors in Fifth-Grade Boys and Girls: Where, With Whom, and Why?

BACKGROUND An understanding of the context surrounding screen- and non-screen-based sedentary behavior would facilitate efforts to reduce childrens overall sedentary behavior. This study examined the prevalence of specific types of sedentary behavior in children, the social and physical contexts surrounding these behaviors, and differences by gender. METHODS Participants included 686 fifth graders participating in the Transitions and Activity Changes in Kids Study (TRACK). The Physical Activity Choices instrument measured child participation in seven sedentary behaviors, the social (i.e., with whom) and physical (i.e., where) contexts, and perceptions (i.e., why) of those behaviors. Analysis included mixed-model regression adjusted for race/ethnicity, BMI, and socioeconomic status. RESULTS Children participated in both screen- and non-screen-based sedentary behaviors at very high frequencies. The most popular activities included watching television or videos, listening to music, playing video games (boys only), and talking on the phone or texting (girls only). Children engaged in sedentary behaviors most often at home, at school, or in their neighborhood. In general, the patterns of social context for the behaviors were similar for boys and girls, with the exception of video game playing. Girls perceived listening to music and talking on the phone or texting to be more fun than boys; children did not differ in their other perceptions (i.e., how much choice or how important) of the behaviors. CONCLUSIONS Multi-level interventions that target reducing sedentary behavior in the home, neighborhood, and school context may be most effective; however, the approach needed will likely differ by gender.

Longitudinal changes in physical activity and sedentary behavior from adolescence to adulthood: Comparing U.S.-born and foreign-born populations

BACKGROUND This study compared moderate-to-vigorous physical activity (MVPA) and sedentary behavior in U.S.-born and foreign-born adolescents and young adults, and differences in behavior change from adolescence to young adulthood by nativity. METHODS Data on 2039 U.S.-born and 225 foreign-born participants from Project EAT-III (Eating and Activity in Teens and Young Adults) were used to examine MVPA, television/ DVD/video viewing, and computer use. Participants completed surveys at baseline in Minneapolis/St. Paul, MN secondary school classrooms in 1998-1999 (14.9 ± 1.6 y) and follow-up measures online or by mail in 2008-2009 (25.3 ± 1.6 y). RESULTS At both time points, foreign-born participants reported significantly lower levels of MVPA than their U.S.-born counterparts (P < .05). Foreign-born females at baseline and follow-up and foreign-born males at follow-up reported less television/DVD/video viewing compared with U.S.-born participants (P < .01). All participants experienced a significant decline in MVPA from baseline to follow-up (P < .001). Between-group analyses revealed a significantly greater decline in television/DVDs/video viewing for the foreign-born males compared with U.S.-born males from baseline to follow-up (mean change: foreign-born: -4.8 ± 1.32 hrs/wk, U.S.-born: -0.6 ± 0.6 hrs/wk; P < .01). CONCLUSIONS Differences in activity patterns between foreign-born and U.S.-born youth into young adulthood may contribute to disparities in chronic disease risk. Nativity, along with the social, environmental, and cultural context, should be considered when designing programs to promote MVPA and prevent obesity.

Physical activity behavior and related characteristics of highly active eighth-grade girls.

PURPOSE Although girls are generally less physically active than boys, some girls regularly engage in high levels of physical activity (PA); however, very little is known about these girls and how they differ from those who are less physically active. This study examined the PA behavior and related characteristics of highly active adolescent girls and compared them with those who are less active. METHODS Data from 1,866 eighth-grade girls from six field centers across the United States participating in the Trial of Activity for Adolescent Girls (TAAG) were included in the present analysis. Mixed-model analysis of variance examined differences in sociodemographic, anthropometric, psychosocial, and physical activity (accelerometry and self-report) variables between high- and low-active girls; effect sizes were calculated for the differences. RESULTS High-active girls were taller, had lower body mass indices and body fat, and were less sedentary. High-active girls scored higher on self-efficacy, enjoyment of PA, self-management strategies, outcome-expectancy value, and support from family and friends than low-active girls. Low-active girls participated in more leisure time and educational sedentary activities than high-active girls. High-active girls participated in more PA classes/lessons outside of school, team sports, and individual sports. They were also more likely to participate in sports in an organized setting in the community or at school than low-active girls. CONCLUSIONS Health promotion efforts should focus on decreasing the amount of time girls spend in sedentary activities and replacing that time with organized PA opportunities; such efforts should seek to minimize perceived barriers and increase self-efficacy and support for PA.

The Modifying Effects of Race/Ethnicity and Socioeconomic Status on the Change in Physical Activity From Elementary to Middle School

PURPOSE Youth physical activity (PA) levels differ by race/ethnicity and socioeconomic status (SES). It is well established that various multilevel factors may influence changes in PA. The present study examined whether the association between the change in individual, interpersonal, and environmental factors and the change in PA is modified by race/ethnicity or SES. METHODS This study followed 643 youths and their parents from suburban and rural South Carolina participating in the Transitions and Activity Changes in Kids (TRACK) Study in 2008-2009 and 2010-2011. We assessed total PA in youth using accelerometry and categorized youth and parent survey data into blocks based on the socioecological model. Multivariate regression growth curve models evaluated whether the association between change in independent variables and change in PA was modified by race/ethnicity or SES. RESULTS PA declined from fifth to seventh grade among all racial/ethnic and SES groups. Associations between the range of variables and change in PA were modified by race/ethnicity but not SES. Blacks did not share any common predictors of change in PA with whites or Hispanics. However, child-reported number of active friends was associated with total PA, and enjoyment of PA was associated with change in PA among both whites and Hispanics. Significant interactions by time varied by racial/ethnic group. CONCLUSIONS The factors that influence changes in youth PA vary by race/ethnicity but not SES. These findings reinforce the complex nature of addressing PA behavior in diverse samples and further support the need for culturally appropriate interventions to promote PA in youth.

Physical activity perceptions, context, barriers, and facilitators from a Hispanic child’s perspective

Background In order to develop effective physical activity interventions and to address the burden of obesity in Hispanic children, qualitative studies are needed to build descriptive theory and expand the state of the science. The purpose of this study is to describe physical activity perceptions, context, facilitators, and barriers from the perspective of Hispanic immigrant-origin children. Method This in-depth, ethnographic study included 14, 6- to 11-year old, first- and second- generation Hispanic children recruited from an afterschool program in Southeastern Pennsylvania, USA. Methods included child observation, field notes, semi-structured interviews, and a PhotoVoice activity. Transcripts and field notes were coded and analyzed using the constant comparison method to identify overarching themes and patterns in the data. Results Data analysis yielded four overarching themes regarding childrens perspectives on physical activity. Children engaged in a variety of physical activities and sedentary behaviors, which differed by physical (e.g., park, outside home, and afterschool programs) and social (e.g., parents, siblings, and friends) contexts. Children discussed specific benefits of physical activity. Childrens negative attitudes toward physical activity were related to physical discomfort, low athletic competence, and safety concerns. Children perceived physical activity and play to be one in the same, and “fun” was identified as a primary driver of physical activity preferences. The facilitators and barriers to physical activity were related to specific parent/home, school, and neighborhood factors. Conclusion Findings from this study suggest that an emphasis on fun and active play, while taking into account family and neighborhood context, may be a desirable intervention approach in Hispanic immigrant-origin children. This study lays the groundwork for future studies to further explore some of the themes identified here to better understand childrens conceptualization of and experience with physical activity. Such research may inform the design of programs to increase physical activity or active play, and ultimately promote health and well-being, in this at-risk population.

Stepping It Up: Walking Behaviors in Children Transitioning from 5th to 7th Grade

The purpose of this study was to (1) describe children’s walking behaviors in 5th to 7th grade and change over time and (2) examine associations between walking behaviors and Walk Score®. Participants consisted of n = 586 students from the Transitions and Activity Changes in Kids (TRACK) Study. Children reported any walking behavior (e.g., exercise and transportation) over the past five days. Walk Score was calculated based on children’s home address. Descriptive statistics summarized walking behaviors by gender and time, and repeated measure mixed models examined the relationship between walking behaviors and Walk Score. Approximately 46.8% and 19.2% of 5th grade children reported walking for exercise and transportation, respectively, and these percentages declined through 7th grade. Girls reported higher levels of total walking behavior and walking for exercise than boys (p < 0.001). Girls with a higher Walk Score had 63% higher odds of reporting walking for transportation than girls with a lower Walk Score (OR = 1.63, 95% CI = 1.02, 2.62). Walking behaviors among children were infrequent with significant declines over time, and of the nine associations examined with Walk Score, only one was significant. Efforts should prioritize frequent walking behavior and community design to increase children’s physical activity.

Physical Activity in Latino Men and Women: Just One Piece of the Puzzle

This article provides commentary on the accompanying manuscript, “Physical Activity in Latino Men and Women: Facilitators, Barriers, and Interventions” by Larsen and colleagues. A major strength of the Larsen manuscript is that it draws attention to the need for more research on the facilitators and barriers of physical activity in this population, particularly Latino men, and the need for more effective physical activity interventions. This commentary presents some additional insights surrounding the 29 physical activity interventions in Latinos that were identified and directions for future research. In order to expand the state of the science regarding physical activity in Hispanic/Latino populations, researchers should expand their investigation to identify important social determinants of health, include voices from the Latino community in the research process, and use state of the art measures to assess outcome variables.