Tal Shimony

Prevalence and determinants of physical activity and lifestyle in relation to obesity among schoolchildren in Israel.

OBJECTIVE To describe the relationships between physical activity, lifestyle determinants and obesity in adolescent Israeli schoolchildren.Design and settingCross-sectional survey. SUBJECTS The MABAT Youth Survey was a nationally representative, school-based study of youth in grades 7 to 12 (ages 11-19 years). METHODS Self-administered questionnaires assessed health behaviours and anthropometric indices were measured. Logistic regression analysis was used to examine the associations between obesity, physical activity, socio-economic status and other lifestyle habits. One-way ANOVA was used to determine mean physical activity levels (MET values) by BMI categories. RESULTS The prevalence of overweight was 13-15 % and of obesity 4-9 % depending on gender and ethnicity, and was higher among the non-Jewish sectors. Thirty-six per cent and 57 % of Jewish girls and boys, and 40 % and 58 % of non-Jewish girls and boys, respectively, were optimally active. Boys from low socio-economic schools and those who slept for less than 6 h at night were less active. Girls from middle school were found to be 53 % more optimally physically active among Jews, and 89 % more among non-Jews, compared with girls from high school (P = 0.001); girls with less educated parents were also less physically active. No clear relationship was found between the level of obesity and physical activity. CONCLUSIONS Physical inactivity was strongly related to gender, age, social status, sleeping habits, hookah smoking, and parental educational status. Education and intervention programmes should focus on these risk factors.

Determinants of disordered eating behaviors among Israeli adolescent girls.

Eating behaviors were assessed by a modified SCOFF questionnaire in a National representative cross-sectional study among 2978 Israeli schoolgirls. The mean age was 14.7. Thirty percent met the criteria for disordered eating. Being Jewish or underweight reduced the odds for disordered eating. The following increased the risk: dieting, early onset of menarche, being overweight or obese, and suffering from constipation. School socio-economic status, physical activity, and smoking status were not contributory. These results help identify possible interventions to prevent the development of disordered eating behaviors.

Loneliness is associated with an increased risk of sedentary life in older Israelis

Objectives: Both loneliness and insufficient physical activity are common in old age. This study investigated the association between loneliness and adherence to recommended guidelines of physical activity in a national sample of Israelis, and examined whether loneliness was a risk factor for insufficient physical activity independent of other variables. Methods: A random sample of 1663 (799 men) older adults aged 65+ reported their physical activity routine, and based on official guidelines were categorized as sufficiently active, insufficiently active, and inactive. In addition, they were divided into lonely or not lonely based on a single question from the Center for Epidemiologic Studies Depression Scale. Results: Chi-square analyses indicated that loneliness, but not living alone, were inversely related to level of physical activity in both genders. Based on multinomial stepwise logistic regressions body mass index, being religious versus secular, self-rated health, and education were associated with engaging in physical activity in men (Cox & Snell R 2 = 0.202). Loneliness contributed significantly to explaining the level of participation in physical activity beyond these variables in women, but not in men (Cox & Snell R 2 = 0.197). Conclusions: Loneliness is associated with an increasing risk of inactivity in advanced age in women. Further research inquiring into whether loneliness is the cause of reduced physical activity or whether physical activity acts as a protective factor against loneliness is needed. Developing and implementing tailored intervention programs that encourage social interaction in combination with a physical activity program are recommended.

Adolescents' physical activity habits--results from a national health survey.

BACKGROUND   The MABAT Youth National Health and Nutrition Survey was conducted in Israel by the Ministry of Health and the Center for Disease Control. This article presents results of physical activity (PA) habits in Israel, in relation to recommendations by world health organizations. METHODS   Participants were 6274 adolescents, grades 7-12, enrolled in a cross-sectional, representative, school-based survey. Sufficient level of PA was defined as any moderate and vigorous level of PA that adds up daily to 60 min/day. Light PA was considered to be an insufficient level of PA. RESULTS   Only 10.5% of the participants reported performing sufficient PA. Large gender differences were found, with 17.7% of boys versus only 4.6% of girls meeting the guidelines. CONCLUSIONS   Results highlight the need to develop programmes for school children in Israel to promote PA. Such programmes have been initiated in many countries that have a large percentage of adolescents with a sedentary lifestyle.

Ethnic Differences in Patterns of Secondhand Smoke Exposure Among Adolescents in Israel

INTRODUCTION Adolescent secondhand smoke exposure (SHSe) is associated with smoking initiation and independently damages health. METHODS We used data from the school-based 2003-2004 Israel National Health and Nutrition Youth survey (MABAT) to examine patterns and determinants of SHSe in a multiethnic sample of Israeli adolescents. School and child response rates were high (school: 91.8%, child: 87.9%), with 6,274 participants. We used generalized estimating equations to examine SHSe determinants. RESULTS Most Israeli adolescents were exposed to SHS (total: 85.6%; home: 40%; school: 31.4%; entertainment: 73.3%; other: 16.3%). Exposure patterns differed between the Jewish and non-Jewish sectors. Jews were more frequently exposed at school and entertainment venues than were non-Jews but were less frequently exposed at home. Druze were the least exposed and non-Arab Christians the most exposed. Secular Jews were more exposed than were religious Jews; the opposite was true among Arabs. Children of less-educated fathers were exposed more than children of more-educated fathers. Adolescents who smoked were more exposed than were nonsmokers. CONCLUSIONS The high levels of SHSe among Israeli adolescents were characterized by different patterns of exposure among different population groups. Interventions to reduce adolescent SHSe, with appropriate tailoring, are urgently needed. These findings provide support for sustainable implementation of the recent governmentally approved tobacco control plan, which includes extended legislation for, and increased enforcement of, laws about smoking bans in schools and entertainment venues. Researchers elsewhere should be aware that levels and patterns of SHSe may vary greatly by subpopulation.

Level of physical activity and anthropometric characteristics in old age—results from a national health survey

Advanced age is associated with degenerative changes in body composition. There is evidence suggesting that changes may vary upon differences in lifestyle, environment, or gender. Physical activity engagement is considered an important component of lifestyle definition. There are suggestions that engaging in physical activity might alleviate degenerative body compositional changes. The objective is to assess the relationship between adherence to recommended guidelines of physical activity and anthropometric parameters in Israeli older adults. Anthropometric measures, including height, weight, and waist circumference, were taken, and BMI was calculated, from a random sample of 1,663 elderly adults (799 men and 864 women), aged 74.31 (±6.05) years old. Participants reported their physical activity habits and, based on official guidelines recommendations, they were divided into sufficiently active, insufficiently active, and inactive groups. One-way ANOVA (level of physical activity) for both genders was conducted for each anthropometric variable. In both genders, an association between level of physical activity and weight, waist circumference, and BMI was found, with lower values among the sufficiently active. In addition, a relationship between level of physical activity and height was indicated among women, implying that the more active women were taller than the less active. In addition to the already known health benefits of physical activity in old age, it is possible that adherence to recommended guidelines of physical activity is associated with favorable anthropometric characteristics.

Psychological functioning and adherence to the recommended dose of physical activity in later life: results from a national health survey

BACKGROUND Official health organizations have established the dose of physical activity needed for preserving both physical and psychological health in old age. The objective of this study was to explore whether adherence to the recommended criterion of physical activity accounted for better psychological functioning in older adults in Israel. METHODS A random sample of 1,663 (799 men) Israelis reported their physical activity routine, and based on official guidelines were divided into sufficiently active, insufficiently active, and inactive groups. The General Health Questionnaire (GHQ) was used for assessing mental health and the Mini-Mental State Examination (MMSE) for assessing cognitive functioning. RESULTS Factor analysis performed on the GHQ yielded two factors - positive and negative. Logistic regressions for the GHQ factors and for the MMSE were conducted for explaining their variance, with demographic variables entered first, followed by health and then physical activity. The explained variance in the three steps was Cox and Snell R2 = 0.022, 0.023, 0.039 for the positive factor, 0.066, 0.093, 0.101 for the negative factor, and 0.204, 0.206, 0.209 for the MMSE. CONCLUSIONS Adherence to the recommended dose of physical activity accounted for better psychological functioning beyond demographic and health variables; however, the additional explained variance was small. More specific guidelines of physical activity may elucidate a stronger relationship, but only randomized controlled trials can reveal cause-effect relationship between physical activity and psychological functioning. More studies are needed focusing on the positive factor of psychological functioning.

Prediction of standing height among Israeli older adults: Results from a national survey

Background: An accurate measurement of full height while standing is sometimes not possible among older adults, in particular among the frail elderly. For such cases, the use of knee height (KH) and ulna bone length (UL) has been suggested for standing height estimation. Studies have shown that predictive equations of height were ethnic-specific. Aim: This study attempted to develop representative equations to predict standing height based on KH, UL and waist circumference (WC) for older adult Israeli women and men. Subjects and methods: A random sample of 1500 older adults (aged 74.48 ± 6.09 years old). Participants were interviewed in their homes and measurements of Standing height, KH, UL and WC were taken. A quadratic regression analysis, for each sex separately, was performed to predict standing height based on age, KH, UL and WC. Results: The adjusted r 2 standing height prediction equations were 0.51 and 0.67 for women and men, respectively. Conclusions: The prediction of the standing height of frail elderly Israelis, by KH, UL, WC and age, may be an alternative method when actual standing height is difficult or not possible to measure.

Socioeconomic inequalities in exposure to environmental tobacco smoke in children in Israel

BACKGROUND Environmental tobacco smoke (ETS) exposure in infants and children causes more frequent and severe asthma attacks, respiratory infections, ear infections, and sudden infant death syndrome. The aim of this study was to measure ETS exposure in children in Israel (ages 4-11 years) using urinary cotinine measurements, in order to compare exposure levels to other international populations, and to assess predictors of ETS exposure in children in Israel. METHODS A subset of children who participated in the National Health and Nutrition Survey (RAV- MABAT) in 2015-2016 were invited to participate in the Second Israel Biomonitoring Survey. We analyzed urinary cotinine and creatinine concentrations in 103 children. Parents of study participants were interviewed in person on childrens exposure to ETS at home and in other environments and on sociodemographic variables. We calculated creatinine-adjusted and unadjusted urinary cotinine geometric means in children and analyzed associations in univariable and multivariable analyses, between sociodemographic variables and parental - reported exposure, and urinary cotinine concentrations. RESULTS Based on urinary creatinine measurement, over 60% of children are exposed to ETS (compared to <40% based on parental report). Linear regression showed a positive association between urinary cotinine concentration and reported ETS exposure (p = 0.001). Mean cotinine concentration among children whose parents reported that they are exposed to ETS at home (5.1 μg/l) was significantly higher than the concentration among children whose parents reported they are not exposed to ETS at home (1.6 μg/l, p < 0.001). There was an inverse relationship between total family income and urinary cotinine concentration (p < 0.05). In a multivariable model adjusted for ethnicity and other factors, family income was a significant predictor of urinary cotinine level (p = 0.04, slope = -0.49). Geometric mean creatinine adjusted concentrations in children in the current study were higher than in children in Canada and selected European countries. CONCLUSIONS We found evidence of widespread exposure to ETS in children in the study. There is an urgent need to protect children in Israel from exposure to ETS.