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ABSTRACT: OBJECTIVE: Approximately one-third of children in the USA are either overweight or obese. Understanding the perceptions of children is an important factor in reversing this trend. DESIGN: An online survey was conducted with children to capture their perceptions of weight, overweight, nutrition, physical activity and related socio-behavioural factors. SETTING: Within the USA. SUBJECTS: US children (n 1224) aged 8-18 years. RESULTS: Twenty-seven per cent of children reported being overweight; 47·1 % of children overestimated the rate of overweight/obesity among US children. A higher percentage of self-classified overweight children (81·9 %) worried about weight than did self-classified under/normal weight children (31·1 %). Most children (91·1 %) felt that it was important to not be overweight, for both health-related and social-related reasons. The majority of children believed that if someone their age is overweight they will likely be overweight in adulthood (93·1 %); get an illness such as diabetes or heart disease in adulthood (90·2 %); not be able to play sports well (84·5 %); and be teased or made fun of in school (87·8 %). Children focused more on food/drink than physical activity as reasons for overweight at their age. Self-classified overweight children were more likely to have spoken with someone about their weight over the last year than self-classified under/normal weight children. CONCLUSIONS: Children demonstrated good understanding of issues regarding weight, overweight, nutrition, physical activity and related socio-behavioural factors. Their perceptions are important and can be helpful in crafting solutions that will resonate with children.
Public Health Nutrition 11/2012; · 2.17 Impact Factor
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ABSTRACT: Dietary factors vary widely among ethnic groups. However, the effect of specific nutrients on cardiometabolic risk is not well understood, especially in children. Four dietary factors known to influence cardiometabolic risk (ie, carbohydrate, saturated, monounsaturated, and polyunsaturated fat intake) were assessed by the Block Kids 2004 Food Frequency Questionnaire in a cross-sectional sample of racially diverse fourth- through eighth-grade students (n=148) in a Boston-area school district studied between January and April 2010. Fasting total cholesterol, low-density lipoprotein, high-density lipoprotein (HDL) cholesterol, triglyceride, C-reactive protein (CRP), and interleukin-6 (IL-6) levels, and body mass index z scores were measured. Differences in dietary factors and cardiometabolic risk factors were examined among the following racial/ethnic groups: white (39%), Hispanic (32%), black (8%), Asian (10%), and multiracial/other (11%). In bivariate analyses, total, saturated, and polyunsaturated fat intakes differed by race/ethnicity (P<0.05), with white and black children reporting saturated fat intakes above the recommended level. Forty-seven percent of children had at least one suboptimal cardiometabolic risk factor. HDL cholesterol, triglyceride, and IL-6 concentrations differed by race/ethnicity (P<0.05, P<0.01, and P<0.01, respectively), with Hispanics having low HDL cholesterol levels and high triglyceride levels, whereas Asians had high IL-6 levels. In multivariate analyses controlling for demographic characteristics, none of the dietary factors examined explained racial/ethnic differences in lipid profiles or inflammatory markers. Body mass index z score was associated with lower HDL cholesterol, higher triglyceride, higher CRP, and higher IL-6 levels (P<0.0001). Further research is warranted to determine the influence of dietary recommendations at a young age among different racial/ethnic groups on cardiometabolic health.
Journal of the Academy of Nutrition and Dietetics. 11/2012; 112(11):1815-21.
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ABSTRACT: OBJECTIVE: To examine the relationship between intake of whole grains and BMI Z-score in rural children. DESIGN: General linear models and logistic regression were used to examine the cross-sectional associations between whole grain intake and BMI Z-score, prevalence and odds ratios of overweight and obesity. Dietary intake was assessed using the Block Food Screener for ages 2-17 years. Children were classified into three categories according to servings of whole grain intake: <1·0 serving/d, 1·0-1·5 servings/d and >1·5 servings/d. SETTING: The CHANGE (Creating Healthy, Active and Nurturing Growing-up Environments) study, an obesity prevention intervention in elementary schools in eight rural US communities in California, Mississippi, Kentucky and South Carolina. SUBJECTS: Seven hundred and ninety-two children attending 3rd-6th grade. RESULTS: After adjusting for age, sex, race/ethnicity, physical activity and state of residence, whole grain intake was inversely associated with BMI Z-score (0·90 v. 0·61 in the lowest v. the highest whole grain intake category; P trend = 0·01). Children who consumed >1·5 servings of whole grains/d had a 40 % lower risk of being obese (OR = 0·60; 95 % CI 0·38, 0·95, P = 0·02) compared with children who consumed <1·0 serving/d. Further adjustment for potential dietary predictors of body weight (fruit, vegetable and dairy intakes) did not change the observed associations. CONCLUSIONS: Increasing the intake of whole grains as part of an overall healthy lifestyle may be beneficial for children to achieve and maintain a healthy weight.
Public Health Nutrition 08/2012; · 2.17 Impact Factor
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ABSTRACT: Low serum vitamin D, which largely affects ethnic minorities, is associated with obesity and other chronic diseases. Little is known about racial/ethnic differences in intake, particularly in children, or if any differences are associated with differences in serum 25-hydroxyvitamin D (25(OH)D). The objective of the present study was to determine whether racial/ethnic differences in dietary vitamin D intake exist and whether they explain differences in 25(OH)D.
Vitamin D intakes (Block Kids 2004 FFQ) and 25(OH)D were measured. Race/ethnicity was parent-reported (white (37·9 %), Hispanic (32·4 %), black (8·3 %), Asian (10·3 %), multi-racial/other (11·0 %)). Multivariable analyses were conducted to examine the associations among dietary vitamin D and race/ethnicity, as well as 25(OH)D, independent of BMI Z-score and other covariates.
Elementary/middle schools in Somerville, MA, USA, during January-April 2010.
Schoolchildren (n 145) in 4th-8th grade.
Only 2·1 % met the 2011 RDA (15 μg/d (600 IU/d)). Average dietary intake was 3.5 (sd 2.2) μg/d (140 (sd 89·0) IU/d). No racial/ethnic differences in intake were evident. Most (83·4 %) were 25(OH)D deficient (<20 ng/ml; 16·0 (sd 6·5) ng/ml). In ANOVA post hoc analyses, 25(OH)D levels were lower in Hispanics than whites (14·6 (sd 6·1) ng/ml v. 17·9 (sd 4·6) ng/ml; P < 0·01). Dietary vitamin D was associated with 25(OH)D overall (P < 0·05), but did not explain the racial/ethnic differences in 25(OH)D.
Most children in this north-east US sample did not meet dietary recommendations for vitamin D and were vitamin D deficient. Dietary vitamin D did not explain the difference in 25(OH)D between Hispanic and white children. Further research is needed to determine if changes in dietary vitamin D by race/ethnicity can impact 25(OH)D levels.
Public Health Nutrition 08/2012; 15(11):2047-53. · 2.17 Impact Factor
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ABSTRACT: There are disproportionately higher rates of overweight and obesity in poor rural communities but studies exploring children's health-related behaviors that may assist in designing effective interventions are limited. We examined the association between overweight and obesity prevalence of 401 ethnically/racially diverse, rural school-aged children and healthy-lifestyle behaviors: improving diet quality, obtaining adequate sleep, limiting screen-time viewing, and consulting a physician about a child's weight.
A cross-sectional analysis was conducted on a sample of school-aged children (6-11 years) in rural regions of California, Kentucky, Mississippi, and South Carolina participating in CHANGE (Creating Healthy, Active, and Nurturing Growing-up Environments) Program, created by Save the Children, an independent organization that works with communities to improve overall child health, with the objective to reduce unhealthy weight gain in these school-aged children (grades 1-6) in rural America. After measuring children's height and weight, we17 assessed overweight and obesity (BMI ≥ 85th percentile) associations with these behaviors: improving diet quality18 (≥ 2 servings of fruits and vegetables/day), reducing whole milk, sweetened beverage consumption/day; obtaining19 adequate night-time sleep on weekdays (≥ 10 hours/night); limiting screen-time (i.e., television, video, computer,20 videogame) viewing on weekdays (≤ 2 hours/day); and consulting a physician about weight. Analyses were adjusted 21 for state of residence, children's race/ethnicity, gender, age, and government assistance.
Overweight or obesity prevalence was 37 percent in Mississippi and nearly 60 percent in Kentucky. Adjusting for covariates, obese children were twice as likely to eat ≥ 2 servings of vegetables per day (OR=2.0,95% CI 1.1-3.4), less likely to consume whole milk (OR=0.4,95% CI 0.2-0.70), Their parents are more likely to be told by their doctor that their child was obese (OR=108.0,95% CI 21.9-541.6), and less likely to report talking to their child about fruits and vegetables a lot/sometimes vs. not very much/never (OR=0.4, 95%CI 0.2-0.98) compared to the parents of healthy-weight children.
Rural children are not meeting recommendations to improve diet, reduce screen time and obtain adequate sleep. Although we expected obese children to be more likely to engage in unhealthy behaviors, we found the opposite to be true. It is possible that these groups of respondent parents were highly aware of their weight status and have been advised to change their children's health behaviors. Perhaps given the opportunity to participate in an intervention study in combination with a physician recommendation could have resulted in actual behavior change.
BMC Pediatrics 07/2012; 12:102. · 1.88 Impact Factor
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ABSTRACT: Our goal was to explore the perceived determinants of obesity in Brazilian, Latin American and Haitian women. This is part of an ongoing community-based participatory intervention. Focus groups by immigrant group were conducted and themes extracted. Women expressed differences in beliefs, attitudes, and barriers regarding diet and physical activity in the US versus their home country. Participants thought food in the US is "less natural," there is less time for preparation, and there is more variety. The weather is a barrier to physical activity in the US and work is more physically demanding. Job-related efforts were not considered physical activity. They reported higher levels of stress, less control of their time and less social support in the US. Providing immigrants with appropriate support and education early in the acculturation process has the potential to help prevent obesity.
Journal of Immigrant and Minority Health 06/2012; · 1.16 Impact Factor
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Alison Tovar,
Erin Hennessy,
Alex Pirie,
Aviva Must,
David M Gute,
Raymond R Hyatt,
Christina Luongo Kamins,
Sheryl O Hughes,
Rebecca Boulos,
Sarah Sliwa,
Heloisa Galvão, Christina D Economos
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ABSTRACT: Research has shown that parental feeding styles may influence children's food consumption, energy intake, and ultimately, weight status. We examine this relationship, among recent immigrants to the US. Given that immigrant parents and children are at greater risk for becoming overweight/obese with increased time in the US, identification of risk factors for weight gain is critical.
Baseline data was collected on 383 mother-child dyads enrolled in Live Well, a community-based, participatory, randomized controlled lifestyle intervention to prevent weight gain in recent immigrant mothers. Socio-demographic information together with heights and weights were collected for both mother and child. Acculturation, behavioral data, and responses to the Caregiver's Feeding Styles Questionnaire (CFSQ) were also obtained from the mother.
The children's average age was 6.2 ± 2.7 years, 58% male. Mothers had been in the country for an average of 6.0 ± 3.3 years, and are Brazilian (36%), Haitian (34%) and Latino (30%). Seventy-two percent of the mothers were overweight/obese, while 43% of the children were overweight/obese. Fifteen percent of mothers reported their feeding style as being high demanding/high responsive; 32% as being high demanding/low responsive; 34% as being low demanding/high responsive and 18% as being low demanding/low responsive. In bivariate analyses, feeding styles significantly differed by child BMIz-score, ethnic group, and mother's perceived stress. In multiple linear regression, a low demanding/high responsive feeding style was found to be positively associated (ß = 0.56) with a higher child weight as compared to high demanding/high responsive, controlling for known covariates (p = 0.01).
Most mothers report having a low demanding/high responsive feeding style, which is associated with higher child weight status in this diverse immigrant population. This finding adds to the growing literature that suggests this type of feeding style may be a risk factor for childhood obesity. Further research is needed to help understand the larger socio-cultural context and its influence on feeding dynamics among immigrant families and families of lower incomes. How parents establish a certain feeding style in their home country compared to when they move to the US "obesogenic" environment, should also be explored.
International Journal of Behavioral Nutrition and Physical Activity 05/2012; 9:62. · 3.83 Impact Factor
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ABSTRACT: Physical fitness is often inversely associated with adiposity in children cross-sectionally, but the effect of becoming fit or maintaining fitness over time on changes in weight status has not been well studied in children. We investigated the impact of changes in fitness over 1-4 years of follow-up on the maintenance or achievement of healthy weight among 2,793 schoolchildren who were first measured as 1st to 7th graders. Students were classified as "fit" or "underfit" according to age- and gender-specific norms in five fitness domains: endurance, agility, flexibility, upper body strength, and abdominal strength. Weight status was dichotomized by BMI percentile: "healthy weight" (<85th percentile) or "overweight/obese" (≥85th percentile). At baseline, of the 38.3% overweight/obese children, 81.9% (N = 875) were underfit. Underfit overweight students were more likely to achieve healthy weight if they achieved fitness (boys: odds ratio (OR) = 2.68, 95% confidence interval (CI) = 1.24-5.77; girls: OR = 4.67, 95%CI = 2.09-10.45). Initially fit overweight children (N = 194) were more likely to achieve healthy weight if they maintained fitness (boys: OR = 11.99, 95%CI = 2.18-65.89; girls: OR = 2.46, 95%CI = 1.04-5.83). Similarly, initially fit healthy-weight children (N = 717) were more likely to maintain healthy weight if they maintained fitness (boys: OR 3.70, 95%CI = 1.40-9.78; girls: OR = 4.14, 95%CI = 1.95-8.78). Overweight schoolchildren who achieve or maintain physical fitness are more likely to achieve healthy weight, and healthy-weight children who maintain fitness are more likely to maintain healthy weight. School-based policies/practices that support physical fitness may contribute to obesity reduction and maintenance of healthy weight among schoolchildren.
Obesity 02/2012; 20(8):1710-7. · 4.28 Impact Factor
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ABSTRACT: Prevention of childhood obesity is a societal priority. Despite our knowledge about the scope of the problem and the determinants that lead to it, we have yet to produce meaningful declines in obesity rates. Recent attention has been given to interventions that employ multiple strategies across multiple settings involving whole communities given their promising results. The next era of science calls for interdisciplinary teams who will envision a whole system approach to advance the community-based obesity prevention model. This perspective describes some of the more recent discussions of community-based methodologies such as the ANGELO (Analysis Grid for Environments Linked to Obesity) framework, best-practice principles, and a whole system intervention approach to obesity prevention. The proposed required elements to advance community-based research to address childhood obesity are: A systems perspective and approach, training of future leaders in community research methodology and social change, applying transdisciplinary strategies, funding to conduct rigorous trials to determine efficacy and effectiveness, enhanced design and analysis approaches, new and improved tools and methodologies to collect quantitative and qualitative data, enhanced community engagement models and sustainability frameworks, advancement of a bold public policy agenda, economic modeling, and acknowledgment of the approach as viable. To reverse childhood obesity, we need to embrace and integrate complex strategies at multiple levels within communities across the globe.
Childhood obesity (Print). 02/2012; 8(1):19-22.
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ABSTRACT: There are few weight gain prevention interventions aimed at new immigrants. Live Well, a community-based participatory research (CBPR) study, was designed to address this gap.
The goal of this paper is to describe the development of the Live Well nutrition and physical activity curriculum.
The curriculum draws on behavioral theory and popular education and was co-created, implemented, and will be evaluated by community partners and academic researchers.
The time it took to develop the curriculum exceeded initial estimates. However, the extra time taken was spent engaging in needed dialogue to create a better product, fully co-created by academic and community partners. Additionally, working with an outside expert created the opportunity for all partners to train together, build capacity, and increase cohesion. Our approach developed relationships and trust, and resulted in a unique curriculum.
The commitment to partnership resulted in a curriculum to empower immigrant women to improve health decisions and behaviors. This will inform future research and programming targeting other at-risk and new immigrant communities.
Progress in community health partnerships: research, education, and action 01/2012; 6(2):195-204.
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ABSTRACT: Parents play an important role in shaping children's eating habits. Few studies have evaluated the influence of both parenting style and parenting practices on child outcomes such as dietary intake. During spring 2007, 99 parent-child dyads from four rural US areas participated in this cross-sectional study. Child food intake was reported during two interviewer-administered, parent-assisted 24-hour recalls. Diet quality was defined as the average number of low-nutrient-dense (LND) foods consumed. Validated questionnaires were used to assess parental feeding practices and feeding style. Pearson correlations identified relationships among child food intake, parental feeding style typologies, and covariates. Regression analyses were used to predict child diet quality. Sixty percent of children and 76% of parents were overweight or obese. A permissive feeding style, which is highly responsive to a child's requests and sets few demands on him or her, was the most common (n=37) parental feeding style. This feeding style was associated with child intake of LND foods (r=0.3; P<0.001) and moderated the relationship between parental feeding practices and child intake of LND foods. In the presence of a permissive feeding style, higher levels of monitoring were associated with child intake of LND foods (β=.69; P<0.05). Parental feeding style may alter the effectiveness of parental feeding practices on children's food intake. More research is needed to understand the parent-child feeding relationship in the context of parental feeding styles and practices.
Journal of the Academy of Nutrition and Dietetics. 01/2012; 112(1):142-8.
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ABSTRACT: Researchers use the Caregiver's Feeding Styles Questionnaire (CFSQ) to categorize parent feeding into authoritative, authoritarian, indulgent, and uninvolved styles. The CFSQ assesses self-reported feeding and classifies parents using median splits which are used in a substantial body of parenting literature and allow for direct comparison across studies on dimensions of demandingness and responsiveness. No national norms currently exist for the CFSQ. This paper establishes and recommends cutoff points most relevant for low-income, minority US samples that researchers and clinicians can use to assign parents to feeding styles. Median scores for five studies are examined and the average across these studies reported.
Appetite 11/2011; 58(1):393-5. · 2.59 Impact Factor
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Sarah Sliwa,
Jeanne P Goldberg,
Valerie Clark,
Jessica Collins,
Ruth Edwards,
Raymond R Hyatt,
Bridgid Junot,
Elizabeth Nahar,
Miriam E Nelson,
Alison Tovar, Christina D Economos
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ABSTRACT: To build on a growing interest in community-based obesity prevention programs, methods are needed for matching intervention strategies to local needs and assets. We used the Community Readiness Model (CRM), a structured interview guide and scoring system, to assess community readiness to act on childhood obesity prevention, furthering a replication study of a successful intervention. Using the CRM protocol, we conducted interviews with 4 stakeholders in each of 10 communities of similar size, socioeconomic status, and perceived readiness to implement a community-wide obesity prevention intervention. Communities were in California, Florida, Illinois, Massachusetts, New York, North Carolina, Pennsylvania, and Tennessee. The 4 stakeholders were the mayor or city manager, the school superintendent, the school food service director, and a community coalition representative. Interviews were recorded and professionally transcribed. Pairs of trained reviewers scored the transcriptions according to CRM protocol. The CRM assesses 9 stages of readiness for 6 dimensions: existing community efforts to prevent childhood obesity, community knowledge about the efforts, leadership, community climate, knowledge about the issue, and resources. We calculated an overall readiness score for each community from the dimension scores. Overall readiness scores ranged from 2.97 to 5.36 on the 9-point scale. The mean readiness score, 4.28 (SD, 0.68), corresponds with a "preplanning" level of readiness. Of the 6 dimensions, community climate varied the least (mean score, 3.11; SD, 0.64); leadership varied the most (mean score, 4.79; SD, 1.13). The CRM quantified a subjective concept, allowing for comparison among 10 communities. Dimension scores and qualitative data from interviews helped in the selection of 6 communities for a replication study.
Preventing chronic disease 11/2011; 8(6):A150. · 1.82 Impact Factor
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ABSTRACT: Evidence supports the role of physical and social environments in active living, including perception of environment. However, measurement of perceived environments in rural settings is lacking. This study describes the development of the Rural Active Living Perceived Environmental Support Scale (RALPESS).
Premised on social ecological and cognitive perspectives, 85 initial items were generated through a literature review and a mixed-methods investigation of "activity-friendly" environments. Items were organized by resource areas--town center, indoor and outdoor physical activity areas, schools, churches, and areas around the home/neighborhood--and submitted for expert panel review. In 2009, a revised questionnaire was disseminated to adolescents, parents, public school staff, and older adults in 2 rural southeastern United States counties. Principal component analysis with varimax rotation was used to explore factor structure (n = 542).
The final analysis yielded 33 items with 7 factors: 1) church facilities, 2) town center connectivity, 3) indoor areas, 4) around the home/neighborhood, 5) town center physical activity resources, 6) school grounds, and 7) outdoor areas.
The RALPESS is a valid, internally consistent, and practically useful instrument to measure perceptions of rural environments in the context of physical activity across the lifespan. Confirmatory factor analysis is recommended to validate factor structure.
Journal of Physical Activity and Health 07/2011; 9(5):724-30.
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ABSTRACT: Amid the childhood obesity epidemic, understanding how organized sports participation contributes to meeting physical activity recommendations in children is important. Anthropometrics were measured in children (n = 111; 68% female, 9.1 ± 0.8 yr) before one 50-min soccer match. Time spent at different physical activity intensity levels was examined using Actigraph accelerometers. 49% of the match time was spent in sedentary activity (25.4 ± 5.7 min), while 33% of the match (16.9 ± 4.7 min) was spent in moderate-to-vigorous activity (MVPA; p < .001). 22.5% of the children were overweight/obese and spent more time in sedentary activity (+3.2 ± 1.2 min; p < .05) and less time in MVPA (-3.0 ± 1.0 min; p < .01) compared with the normal weight children. These data demonstrate that playing an organized sport such as soccer only meets a portion (~25%) of the 60 min of MVPA recommended and even less of this recommendation is met by overweight/obese children.
Pediatric exercise science 05/2011; 23(2):281-92. · 1.71 Impact Factor
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ABSTRACT: Active living integrates physical activity into one's daily routine. Current understanding of active living among children and their families living in rural communities is limited. A community perspective is critical to understand the contextual factors that influence children's physical activity in rural areas.
The purpose of this study was to identify the perceived environmental factors that support or hinder physical activity among rural children to develop testable hypotheses to inform future interventions for reducing unhealthy weight gain and preventing chronic diseases associated with physical inactivity.
PhotoVOICE was used to explore active living opportunities and barriers for children living in four low-income, rural U.S. communities. In 2007, parents (n=99) and elementary school staff (n=17) received disposable cameras to document their perspective. Using their photographs and narratives, participants developed emergent themes during a facilitated group discussion. In 2008, study authors used the Analysis Grid for Environments Linked to Obesity (ANGELO) framework to categorize the themes.
Microenvironment themes include physical (e.g., natural features, topography); sociocultural (e.g., isolation); policy (e.g., time for school recess); and economic (e.g., funding for physical activity programs). Macroenvironmental themes related to the built and natural environments and transportation infrastructure.
This study identified rural environment elements that community members perceived as influencing children's physical activity patterns. Certain aspects were unique to rural areas, whereas other urban and suburban factors may be generalizable to rural settings. PhotoVOICE was a useful participatory research method to gain insight into perceived factors affecting rural children's physical activity behaviors.
American journal of preventive medicine 12/2010; 39(6):537-45. · 4.24 Impact Factor
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ABSTRACT: This study was conducted to compare two different online delivery methods to train after school program leaders (ASPLs) to implement a nutrition and physical activity curriculum for children to each other and to a face-to-face (FTF) training model. A three-group design was used in which ASPLs from 12 states were randomized to either standard (n = 34) or an enhanced interaction (n = 31) online training, while a FTF group (n = 24) served as comparison. All ASPLs completed training and implemented curriculum lessons over 16 weeks from March to June 2007. Weekly evaluations and pre and post-intervention questionnaires compared number of lessons implemented, subjective ratings of lesson success, and pre and post leader nutrition and physical activity knowledge. Multivariate linear regression analyses were used for among-group comparisons, paired Ttests for within-group knowledge change. Knowledge scores increased significantly (p < .001) within each group. All ASPLs fulfilled the goal of conducting at least 9 lessons, and they rated 64% of lessons successful. After adjustment, knowledge change and success scores did not differ among groups. Implementation was significantly higher for FTF (+2.23 lessons, p = .013) than for enhanced interaction, but not for standard. Online training for ASPLs, such as the standard condition, are viable means of nutrition and physical activity education and program dissemination.
Journal of Health Communication 12/2010; 15(8):859-79. · 1.61 Impact Factor
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ABSTRACT: Parents influence their children's behaviors directly through specific parenting practices and indirectly through their parenting style. Some practices such as logistical and emotional support have been shown to be positively associated with child physical activity (PA) levels, while for others (e.g. monitoring) the relationship is not clear. The objectives of this study were to determine the relationship between parent's PA-related practices, general parenting style, and children's PA level.
During the spring of 2007 a diverse group of 99 parent-child dyads (29% White, 49% Black, 22% Hispanic; 89% mothers) living in low-income rural areas of the US participated in a cross-sectional study. Using validated questionnaires, parents self-reported their parenting style (authoritative, authoritarian, permissive, and uninvolved) and activity-related parenting practices. Height and weight were measured for each dyad and parents reported demographic information. Child PA was measured objectively through accelerometers and expressed as absolute counts and minutes engaged in intensity-specific activity.
Seventy-six children had valid accelerometer data. Children engaged in 113.4 ± 37.0 min. of moderate-vigorous physical activity (MVPA) per day. Children of permissive parents accumulated more minutes of MVPA than those of uninvolved parents (127.5 vs. 97.1, p < 0.05), while parents who provided above average levels of support had children who participated in more minutes of MVPA (114.2 vs. 98.3, p = 0.03). While controlling for known covariates, an uninvolved parenting style was the only parenting behavior associated with child physical activity. Parenting style moderated the association between two parenting practices - reinforcement and monitoring - and child physical activity. Specifically, post-hoc analyses revealed that for the permissive parenting style group, higher levels of parental reinforcement or monitoring were associated with higher levels of child physical activity.
This work extends the current literature by demonstrating the potential moderating role of parenting style on the relationship between activity-related parenting practices and children's objectively measured physical activity, while controlling for known covariates. Future studies in this area are warranted and, if confirmed, may help to identify the mechanism by which parents influence their child's physical activity behavior.
International Journal of Behavioral Nutrition and Physical Activity 10/2010; 7:71. · 3.83 Impact Factor
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ABSTRACT: Accumulating evidence suggests that vitamin D is involved in the development of type 2 diabetes (T2D).
Our objective was to examine the relation between vitamin D status and incidence of T2D.
We used a subsample of 1972 Framingham Offspring Study participants to develop a regression model to predict plasma 25-hydroxyvitamin D [25(OH)D] concentrations from age, sex, body mass index, month of blood sampling, total vitamin D intake, smoking status, and total energy intake. Using this model, we calculated the predicted 25(OH)D score for each nondiabetic participant at the cohort's fifth examination to assess the association between the predicted 25(OH)D score and incidence of T2D by using Cox proportional hazards models.
A total of 133 T2D cases were identified over a 7-y average follow-up. In comparison with individuals in the lowest tertile of the predicted 25(OH)D score at baseline, those in the highest tertile had a 40% lower incidence of T2D after adjustment for age, sex, waist circumference, parental history of T2D, hypertension, low HDL cholesterol, elevated triglycerides, impaired fasting glucose, and Dietary Guidelines for Americans Adherence Index score (hazard ratio: 0.60; 95% CI: 0.37, 0.97; P for trend = 0.03).
Our findings suggest that higher vitamin D status is associated with decreased risk of T2D. Maintaining optimal 25(OH)D status may be a strategy to prevent the development of T2D.
American Journal of Clinical Nutrition 06/2010; 91(6):1627-33. · 6.67 Impact Factor
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ABSTRACT: Despite the recognized health benefits, few older women participate in strength-training exercises.
The purpose of this study was to examine factors related to older women's adherence to strength training after participation in the StrongWomen Program, a nationally disseminated community program. Adherence was defined as > or =4 months of twice-weekly strength training. Surveys were sent to 970 program participants from 23 states and to participants' corresponding program leaders. Five-hundred fifty-seven participants responded (57%).
Of respondents who completed surveys (527), 79% (415) adhered to strength training; adherers reported a mean of 14.1 +/- 9.1 months of strength training. Logistic-regression analysis revealed that exercise adherence was positively associated with age (p = .001), higher lifetime physical activity levels (p = .045), better perceived health (p = .003), leader's sports participation (p = .028), and leader's prior experience leading programs (p = .006).
These data lend insight to factors that may be related to exercise adherence among midlife and older women.
Journal of aging and physical activity 04/2010; 18(2):201-18. · 2.09 Impact Factor
