Socio-demographic correlates of prolonged television viewing time in Australian men and women : the AusDiab study

Background: Sedentary behaviors, particularly television viewing (TV) time, are associated with adverse health outcomes in adults, independent of physical activity levels. These associations are stronger and more consistent for women than for men. Methods: Multivariate regression models examined the sociodemographic correlates of 2 categories of TV time (≥2 hours/day and ≥4 hours/day); in a large, population-based sample of Australian adults (4950 men, 6001 women; mean age 48.1 years, range 25-91) who participated in the 1999/2000 Australian Diabetes, Obesity, and Lifestyle (AusDiab) study. Results: Some 46% of men and 40% of women watched ≥ 2 hours TV/day; 9% and 6% respectively watched ≥ 4 hours/day. For both men and women, ≥2 hours TV/day was associated with less than tertiary education, living outside of state capital cities, and having no paid employment. For women, mid and older age (45-64 and 65+) were also significant correlates of ≥2 hours TV/day. Similar patterns of association were observed in those viewing ≥4 hours/day. Conclusions: Prolonged TV time is associated with indices of social disadvantage and older age. These findings can inform the understanding of potential contextual influences and guide preventive initiatives.

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.

A low intensity, community based lifestyle programme to prevent weight gain in women with young children : cluster randomised controlled trial

Objective To develop and evaluate the effectiveness of a community behavioural intervention to prevent weight gain and improve health related behaviours in women with young children.
Design Cluster randomised controlled trial.
Setting A community setting in urban Australia. 
Participants 250 adult women with a mean age of 40. 39 years (SD 4.77, range 25-51) and a mean body mass index of 27.82 kg/m2 (SD 5.42, range 18-47) were recruited as clusters through 12 primary (elementary) schools. Intervention Schools were randomly assigned to the intervention or the control. Mothers whose schools fell in the intervention group (n=127) attended four interactive group sessions that involved simple health messages, behaviour change strategies, and group discussion, and received monthly support using mobile telephone text messages for 12 months. The control group (n=123)
attended one non-interactive information session based on population dietary and physical activity guidelines. 
Main outcome measures The main outcome measures were weight change and difference in weight change between the intervention group and the control group at 12 months. Secondary outcomes were changes in serum concentrations of fasting lipids and glucose, and changes in dietary behaviours, physical activity, and self management behaviours.
Results All analyses were adjusted for baseline values and the possible clustering effect. Women in the control group gained weight over the 12 month study period (0.83 kg, 95% confidence interval (CI) 0.12 to 1.54), whereas those in the intervention group lost weight (−0.20 kg, −0.90 to 0.49). The difference in weight change between the intervention group and the control group at 12 months was −1.13 kg (−2.03 to −0.24 kg; P<0.05) on the basis of observed values and −1.11 kg (−2.17 to −0.04) after multiple imputation to account for possible bias created by missing values. Secondary analyses after multiple imputation showed a difference in the intervention group compared with the control group for total cholesterol concentration (−0.35 mmol/l, −0.70 to −0.001), self management behaviours (diet score 0.18, 0.13 to 0.33; physical activity score 0.24, 0.05 to 0.43), and confidence to control weight (0.40, 0.11 to 0.69). Regular self weighing was associated with weight loss in the intervention group only (−1.98 kg, −3.75 to −0.23).
Conclusions Weight gain in women with young children could be prevented using a low intensity self management intervention delivered in a community setting. Self management of health behaviours improved with the intervention. The response rate of 12%, although comparable with that in other community studies, might limit the ability to generalise to other populations.    
Trial registration Australian New Zealand Clinical Trials Registry number ACTRN12608000110381.

Parenting, family functioning and lifestyle in a new culture : the case of African migrants in Melbourne, Victoria, Australia

This study documented the parenting styles among African migrants now living in Melbourne, Victoria, Australia, and assessed how intergenerational issues related to parenting in a new culture impact on family functioning and the modification of lifestyles. A total of 10 focus group discussions (five with parents and five with 13–17-year-old children; N = 85 participants) of 1.5–2 hours duration were conducted with Sudanese, Somali and Ethiopian migrant families. The analysis identified three discrete themes: (i) parenting-related issues; (ii) family functioning and family relations; and (iii) lifestyle changes and health. African migrant parents were restrictive in their parenting; controlled children's behaviours and social development through strict boundary-setting and close monitoring of interests, activities, and friends; and adopted a hierarchical approach to decision-making while discouraging autonomy among their offspring. Programmes seeking to improve the health and welfare of African migrants in their host countries need to accommodate the cultural and social dimensions that shape their lives. Such programmes may need to be so broad as to apply an acculturation lens to planning, and to assist young people, parents and families in addressing intergenerational issues related to raising children and growing up in a different social and cultural milieu.

Comparing the physiological cost of step-powered video gaming, sedentary video gaming and self paced ambulatory activity in university students

Objectives: Methods for converting inactive video gaming to active video gaming have gained popularity in recent years. This study compared the physiological cost of a new peripheral device that used steps to power video gaming in an interactive manner against sedentary video gaming and self-paced ambulatory activity of university students (aged 19-29 years).
Methods: Nineteen adults (9 male, 10 female) performed six 10-minute activities, namely self-paced leisurely walking, self-paced brisk walking, self-paced jogging, two forms of sedentary video gaming, and step-powered video gaming. Activities were performed in a random order. Physiological cost during the activities was measured using Actiheart.
Results: Energy expenditure during step-powered video gaming (388.8 kcal.h-1) was comparable to the energy expended during brisk walking (373.8 kcal.h-1), and elicited a higher energy cost than sedentary video gaming (124.1 kcal.h-1) but a lower energy cost than jogging (694.5 kcal.h-1).
Conclusion: Overall, step-powered video gaming could be used as an entertaining and appealing tool to increase physical activity, though it should not be used as a complete substitute for traditional exercise, such as jogging.

An index of unhealthy lifestyle is associated with coronary heart disease mortality rates for small areas in England after adjustment for deprivation

Indices of socio-economic deprivation are often used as a proxy for differences in the health behaviours of populations within small areas, but these indices are a measure of the economic environment rather than the health environment. Sets of synthetic estimates of the ward-level prevalence of low fruit and vegetable consumption, obesity, raised blood pressure, raised cholesterol and smoking were combined to develop an index of unhealthy lifestyle. Multi-level regression models showed that this index described about 50% of the large-scale geographic variation in CHD mortality rates in England, and substantially adds to the ability of an index of deprivation to explain geographic variations in CHD mortality rates.

Does the prescriptive lifestyle of Seventh-Day Adventists provide 'immunity' from the secular effects of changes in BMI?

Objective: To examine the effect of Seventh-day Adventist (SDA) membership on ‘immunity’ to the secular effects of changes in BMI.

Design: Three independent, cross-sectional, screening surveys conducted by Sydney Adventist Hospital in 1976, 1986 and 1988 and a survey conducted among residents of Melbourne in 2006.

Subjects: Two hundred and fifty-two SDA and 464 non-SDA in 1976; 166 SDA and 291 non-SDA in 1986; 120 SDA and 300-non SDA in 1988; and 251 SDA and 294 non-SDA in 2006.

Measurements: Height and weight measured by hospital staff in 1976, 1986 and 1988; self-reported by respondents in 2006.

Results: The mean BMI of non-SDA men increased between 1986 and 2006 (P < 0·001) but did not change for SDA men or non-SDA women. Despite small increases in SDA women’s mean BMI (P = 0·030) between 1988 and 2006, this was no different to that of SDA men and non-SDA women in 2006. The diet and eating patterns of SDA men and women were more ‘prudent’ than those of non-SDA men and women, including more fruit, vegetables, grains, nuts and legumes, and less alcohol, meat, sweetened drinks and coffee. Many of these factors were found to be predictors of lower BMI.

Conclusion: The ‘prudent’ dietary and lifestyle prescriptions of SDA men appear to have ‘immunised’ them to the secular effects of changes that occurred among non-SDA men’s BMI. The dietary and lifestyle trends of SDA women did not reflect the increase in their BMI observed in 2006.

Trends in BMI, diet and lifestyle between 1976 and 2005 in North Sydney

Although the prevalence of overweight and obesity in Australia has increased during the past 30 years, little is known about the dietary and behavioural antecedents of body mass index (BMI). We examined changes in mean BMI, diet, and other lifestyle behaviours between 1976 and 2005 and described the cross-sectional associations between these factors and BMI. A series of biennial biomedical surveys by Sydney Adventist Hospital from 1976 to 2005 allowed examination of BMI trends, while the selection of three surveys enabled detailed examination of likely dietary and lifestyle associations. Subjects included in this study were: 384 men and 338 women in 1976; 160 men and 146 women in 1978; 166 men and 141 women in 1980; 164 men and 142 women in 1982; 177 men and 13 women in 1984; 239 men and 227 women in 1986; 210 men and 225 women in 1988; 165 men and 148 women in 1990; 138 men and 167 women in 1992 and 270 men and 62 women in 2005. Height and weight were measured by hospital staff. Mean BMI increased in the early 1990s. Salt, coffee, cola, alcohol and meat consumption, dieting to lose weight and eating between meals were positively associated with BMI while physical activity, food variety, large breakfasts and consumption of spreads were negatively associated. Food consumption and daily activities have important associations with BMI, though their specific associations differ by sex. 'Affluent' lifestyle patterns appear to contribute to higher BMI, while a more 'prudent' lifestyle seems to protect from such increases.

'Mind and body' : a lifestyle programme for people on antipsychotic medication

Rationale Psychiatric illnesses such as schizophrenia and their treatments have consequences in terms of lifestyle, diet and weight.

Aims and objectives ‘Mind and Body’ is a 10-week programme of weekly sessions aimed to improve the health status of people treated with second generation antipsychotic medications.

Methods The programme focuses on a range of lifestyle strategies including diet and exercise and was conducted at a Community Health Centre by professionally qualified staff. Between 2002 and 2006, 50 participants enrolled in, and 30 completed the programme. Measures of body weight, health status (Short Form-36) and blood markets (plasma glucose, haemoglobin A1c and lipid profile) were collected at commencement and completion of the programme.

Results A modest improvement was demonstrated in mean values for the majority of measures collected.

Conclusions A lifestyle program for people treated with antipsychotic medications is achievable and may be worthwhile although gains may be modest.