Stephen Fallows

Physiologic responses and energy expenditure of kinect active video game play in schoolchildren.

OBJECTIVE To evaluate the physiologic responses and energy expenditure of active video gaming using Kinect for the Xbox 360. DESIGN Comparison study. SETTING Kirkby Sports College Centre for Learning, Liverpool, England. PARTICIPANTS Eighteen schoolchildren (10 boys and 8 girls) aged 11 to 15 years. MAIN EXPOSURE A comparison of a traditional sedentary video game and 2 Kinect activity-promoting video games, Dance Central and Kinect Sports Boxing, each played for 15 minutes. Physiologic responses and energy expenditure were measured using a metabolic analyzer. MAIN OUTCOME MEASURES Heart rate, oxygen uptake, and energy expenditure. RESULTS Heart rate, oxygen uptake, and energy expenditure were considerably higher (P < .05) during activity-promoting video game play compared with rest and sedentary video game play. The mean (SD) corresponding oxygen uptake values for the sedentary, dance, and boxing video games were 6.1 (1.3), 12.8 (3.3), and 17.7 (5.1) mL · min-1 · kg-1, respectively. Energy expenditures were 1.5 (0.3), 3.0 (1.0), and 4.4 (1.6) kcal · min-1, respectively. CONCLUSIONS Dance Central and Kinect Sports Boxing increased energy expenditure by 150% and 263%, respectively, above resting values and were 103% and 194% higher than traditional video gaming. This equates to an increased energy expenditure of up to 172 kcal · h-1 compared with traditional sedentary video game play. Played regularly, active gaming using Kinect for the Xbox 360 could prove to be an effective means for increasing physical activity and energy expenditure in children.

Comparison of Body Mass Index (BMI), Body Adiposity Index (BAI), Waist Circumference (WC), Waist-To-Hip Ratio (WHR) and Waist-To-Height Ratio (WHtR) as Predictors of Cardiovascular Disease Risk Factors in an Adult Population in Singapore

Background Excess adiposity is associated with cardiovascular disease (CVD) risk factors such as hypertension, diabetes mellitus and dyslipidemia. Amongst the various measures of adiposity, the best one to help predict these risk factors remains contentious. A novel index of adiposity, the Body Adiposity Index (BAI) was proposed in 2011, and has not been extensively studied in all populations. Therefore, the purpose of this study is to compare the relationship between Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Hip Ratio (WHR), Waist-to-Height Ratio (WHtR), Body Adiposity Index (BAI) and CVD risk factors in the local adult population. Methods and Findings This is a cross sectional study involving 1,891 subjects (Chinese 59.1% Malay 22.2%, Indian 18.7%), aged 21–74 years, based on an employee health screening (2012) undertaken at a hospital in Singapore. Anthropometric indices and CVD risk factor variables were measured, and Spearman correlation, Receiver Operating Characteristic (ROC) curves and multiple logistic regressions were used. BAI consistently had the lower correlation, area under ROC and odd ratio values when compared with BMI, WC and WHtR, although differences were often small with overlapping 95% confidence intervals. After adjusting for BMI, BAI did not further increase the odds of CVD risk factors, unlike WC and WHtR (for all except hypertension and low high density lipoprotein cholesterol). When subjects with the various CVD risk factors were grouped according to established cut-offs, a BMI of ≥23.0 kg/m2 and/or WHtR ≥0.5 identified the highest proportion for all the CVD risk factors in both genders, even higher than a combination of BMI and WC. Conclusions BAI may function as a measure of overall adiposity but it is unlikely to be better than BMI. A combination of BMI and WHtR could have the best clinical utility in identifying patients with CVD risk factors in an adult population in Singapore.

Parents' use and understanding of front-of-pack food labelling, and the impact of socio-economic status

Research has shown that consumers, particularly those of low socio-economic status, find traditional back-of-pack panels to be complex (1,2) The 2004 White Paper has identified the need for a front-of-pack system that allows for informed healthy choices and addresses inequalities in health (3) . Two systems have been most prominently debated; the ‘traffic-light’ (MTL) and ‘guideline daily amount’ (GDA) systems. Research into system effectiveness is limited and inconclusive (4‐10) , but clearly establishes a need to implement a single system. The present study intended to identify (a) the most effective front-of-pack format for parents, (b) format preferences, (c) the formats’ potential for future use and (d) differences across socio-economic groups. Two groups of parents were selected; one from an area of high deprivation (n 53) and one from an area of low deprivation (n 53), recruited through two schools of a similar size (n 212 and n 194, respectively) in the south of Birmingham. Socio-economic status was determined indirectly using census data for the postcode in which the majority of parents attending the schools lived. Indicators included index of multiple deprivation, levels of unemployment, social housing, self-rating of health, educational attainment, as well as numbers accessing free school meals per school. Both quantitative and qualitative methods were utilized. A self-administered parent questionnaire measured current use of front-of-pack labels, understanding of the two systems (through a product-comparison performance test) and format preferences. Statistical analysis was performed. Focus groups were carried out to explore possible barriers to using front-of-pack labels, features leading to preference and likelihood for future use of the systems. Two groups of four to six individuals were carried out per school using a standardized semi-structured discussion guide. Discourse was audio-taped, transcribed and thematically analysed. For both methods of labelling it was requested that the primary shopper within the family should respond in order to ensure that the results held validity amongst the potential label-using population. The results revealed no between-group differences in current use of front-of-pack labelling, although lower socio-economic groups identified more barriers to using them, indicating an ‘at-a-glance’ format might be more relevant to them. Performance tests found that the GDA format best allowed consumers to identify healthy products (mean score 3.08 out of 4 v. 2.79 out of 4; P < 0.01). There was no difference in performance across socio-economic groups. It was established that the MTL system was preferred by all parents for its ease and speed of use, and was also more likely to be used in the future as it is more accessible and attention-grabbing. Although the GDA system was considered informative, it was also thought to be more difficult to use and easy to ignore. In conclusion, the study identified a ‘trade-off’ that may occur in attempting to implement a single system of front-of-pack labelling; between a system that provokes active use but leads to less accurate distinctions between products (MTL), and a system that may be overlooked by parents, but leads to marginally healthier choices (GDA).

A study on whey protein supplement on physical performance and quality of life among elderly patients with chronic obstructive pulmonary disease

Objectives:  To study if whey protein can improve exercise capacity and quality of life among patients with chronic obstructive pulmonary disease (COPD).