Neighbourhood physical activity environments and adiposity in children and mothers : a three-year longitudinal study

Background Although neighbourhood environments are often blamed for contributing to rising levels of obesity, current evidence is based predominantly on cross-sectional samples. This study examined associations between objectively-measured environmental characteristics of neighbourhoods and adiposity cross-sectionally and longitudinally over three years in children and their female carers.

Methods Longitudinal study of 140 5-6 year-old and 269 10-12 year-old children and their female carers (n = 369). At baseline (2001) and follow-up (2004), height and weight were measured among children and self-reported among female carers, and were used to compute BMI z-scores and BMI, respectively. A Geographic Information System determined access to destinations (public open spaces, sports options, walking/cycling tracks), road connectivity (density of cul-de-sacs and intersections, proportion of 4-way intersections, length of 'access' paths (overpasses, access lanes, throughways between buildings)) and traffic exposure (length of 'busy' and 'local' roads) within 800 m and 2 km of home. Univariate and multivariable linear regression analyses examined associations between environmental characteristics and BMI/BMI z-scores at baseline and change in BMI/BMI z-scores over the three years.

Results Cross-sectionally, BMI z-score was inversely associated with length (km) of access paths within 800 m (b = -0.50) and 2 km (b = -0.16) among younger and number of sport/recreation public open spaces (b = -0.14) and length (km) of 'access' paths (b = -0.94) within 800 m and length of local roads within 2 km (b = -0.01) among older children. Among female carers, BMI was associated with length (km) of walking/cycling tracks (b = 0.17) and busy roads (b = -0.34) within 800 m. Longitudinally, the proportion of intersections that were 4-way (b = -0.01) within 800 m of home was negatively associated with change in BMI z-score among younger children, while length (km) of access paths (b = 0.18) within 800 m was significant among older children. Among female carers, options for aerobics/fitness and swimming within 2 km were associated with change in BMI (B = -0.42).

Conclusion A small number of neighbourhood environment features were associated with adiposity outcomes. These differed by age group and neighbourhood scale (800 m and 2 km) and were inconsistent between cross-sectional and longitudinal findings. However, the results suggest that improvements to road connectivity and slowing traffic and provision of facilities for leisure activities popular among women may support obesity prevention efforts.

Are barriers to physical activity similar for adults with and without abnormal glucose Metabolism?

Purpose The purpose of this study was to examine perceived barriers to physical activity among adults with and without abnormal glucose metabolism (AGM), and whether barriers varied according to physical activity status.
Methods The 1999 to 2000 Australian Diabetes, Obesity, and Lifestyle Study (AusDiab) was a population-based cross-sectional study among adults aged ≥25 years. AGM was identified through an oral glucose tolerance test. The previous week’s physical activity and individual, social, and environmental barriers to physical activity were self-reported. Logistic regression analyses examined differences in barriers to physical activity between those with and without AGM, and for those with and without AGM who did and did not meet the minimum recommendation of 150 minutes/week of moderate-to-vigorous intensity physical activity.
Results Of the 7088 participants (47.5 ± 12.7 years; 46% male), 18.5% had AGM. Approximately 47.5% of those with AGM met the physical activity recommendation, compared to 54.7% of those without AGM (P < .001). Key barriers to physical activity included lack of time, other priorities, and being tired. Following adjustment for sociodemographic and behavioral factors, there were few differences in barriers to physical activity between those with and without AGM, even after stratifying according to physical activity.
Conclusions Adults with AGM report similar barriers to physical activity, as do those without AGM. Programs for those with AGM can therefore focus on the known generic adult-reported barriers to physical activity.

Physical activity, sedentary behavior and depression among disadvantaged women

This study investigated associations between components of physical activity (PA; e.g. domain and social context) and sedentary behaviors (SBs) and risk of depression in women from disadvantaged neighborhoods. A total of 3645 women, aged 18–45 years, from disadvantaged neighborhoods, self-reported their PA, SB and depressive symptoms. Crude and adjusted odds ratios and 95% confidence intervals were calculated for each component of PA, SB and risk of depression using logistic regression analyses, adjusting for clustering by women's neighborhood of residence. Being in a higher tertile of leisure-time PA and transport-related PA was associated with lower risk of depression. No associations were apparent for domestic or work-related PA. Women who undertook a small proportion of their leisure-time PA with someone were less likely to be at risk of depression than those who undertook all leisure-time PA on their own. Women reporting greater time sitting at the computer, screen time and overall sitting time had higher odds of risk of depression compared with those reporting low levels. The domain and social context of PA may be important components in reducing the risk of depression. Reducing time spent in SB may be a key strategy in the promotion of better mental health in women from disadvantaged neighborhoods.

Examining influences on boys' and girls' physical activity patterns: the a-class project

Understanding children’s physical activity (PA) patterns and the factors that may influence PA are important for developing interventions within this population. One hundred and ten children aged 9–0 years from 8 schools had their PA patterns assessed over 7 days. Physiological and self-report data were also collected. Multilevel analyses revealed that cardiorespiratory fitness was a consistent, significant and positive predictor of weekday and weekend PA, while the availability of home sedentary activities was a significant but negative predictor of PA. Since a range of variables were associated with PA levels, intervention developers should be cognizant of variables that may influence children’s activity

Is healthy behavior contagious : associations of social norms with physical activity and healthy eating

Background
Social norms are theoretically hypothesized to influence health-related behaviors such as physical activity and eating behaviors. However, empirical evidence relating social norms to these behaviors, independently of other more commonly-investigated social constructs such as social support, is scarce and findings equivocal, perhaps due to limitations in the ways in which social norms have been conceptualized and assessed. This study investigated associations between clearly-defined social norms and a range of physical activity and eating behaviors amongst women, adjusting for the effects of social support.

Methods
Self-report survey data about particular physical activity (leisure-time moderate-vigorous activity; volitional walking; cycling for transport) and eating behaviors (fast food, soft drink and fruit and vegetable consumption), and social norms and support for these, were provided by 3,610 women aged 18-46 years living in socioeconomically disadvantaged neighborhoods in Victoria, Australia.

Results
Results of regression analyses showed that social norms for physical activity and eating behaviors predicted these respective behaviors relatively consistently; these associations generally remained significant after adjustment for social support.

Conclusions
Acknowledging the cross-sectional study design, these data confirm theoretical accounts of the importance of social norms for physical activity and eating behaviors, and suggest that this is independent from social support. Intervention strategies aimed at promoting physical activity and healthy eating could incorporate strategies aimed at modifying social norms relating to these behaviors.

Seasonal reduction in physical activity and flow-mediated dilation in children

Purpose: Cardiovascular disease is a process that has its origins in childhood. Endothelial dysfunction is the earliest detectable manifestation of cardiovascular disease. This study aimed to assess the impact of seasonal changes in physical activity (PA) and body composition on conduit artery endothelial function in children.

Method: We studied 116 children (70 girls aged 10.7 ± 0.3 yr and 46 boys aged 10.7 ± 0.3 yr) on two occasions; in the northern summer (June) and late autumn (November). We assessed flow-mediated dilation (FMD) using high-resolution Doppler ultrasound. Body composition was measured by dual-energy x-ray absorptiometry. PA was assessed using accelerometry.

Results: FMD (10.0% ± 4.3% to 7.9% ± 3.9%, P < 0.001) and PA (94.1 ± 34.8 to 77.8 ± 33.7 min·d-1, P < 0.01) decreased, while percentage body fat increased (27.6% ± 6.8% to 28.0% ± 6.6%, P < 0.001) between summer and autumn. Decreases in FMD correlated with decreases in high-intensity PA (r = 0.23, P = 0.04), and change in high-intensity PA was the only predictor of change in FMD. No relationships were evident between changes in body composition and FMD.

Conclusions: Vascular function decreased between summer and autumn in this cohort. There were no relationships between change in FMD and changes in body composition or low/moderate-intensity PA. The associations between FMD and high-intensity PA suggests that future interventions should encourage this form of behavior, particularly at the times of year associated with lower PA.

A pilot program of physical activity promotion among clients receiving home and community care

Three Victorian local governments cooperated in a pilot study of physical activity promotion as part of home and community care (HACC) service delivery. Thirty-one people receiving HACC volunteered to participate, including completing the Transtheoretical Stages of Change Exercise Questionnaire and the short-form Stanford Health Assessment Questionnaire (HAQ) just before and at 3 months and 6 months after starting regular self-selected physical activity. Twenty-one participants returned questionnaires at 3 months, and 17 participants returned questionnaires at 6 months. Data were analysed using paired t tests and effect sizes were calculated as mean differences. At 3 months, mean improvements were identified on 6 of the 8 HAQDI (disability index) subscales, and in the overall HAQ-DI score. Improvement in dressing and grooming was preserved at 6 months. At either 3 or 6 months, improvements in dressing and grooming, reach, hygiene, and daily activities, and overall HAQ-DI score exceeded the minimum clinically important difference. No improvements were statistically significant, as is likely in a pilot study with a small sample, however, these results suggest that even very small increases in physical activity may afford clinically meaningful improvements in some areas of physical function required for independent living.

Social ideological influences on food consumption, physical activity and BMI

We investigated relationships between ideological beliefs (i.e., diaphanous body image and environmental concerns), food attitudes, evening meal patterns, physical activity, and Body Mass Index (BMI). A behavioural model was hypothesized based on the Theory of Reasoned Action. A survey was conducted among shoppers aged 40–70 years at Eastland Shopping Centre, Melbourne, Australia. The hypothesized model was tested among female baby boomers (n = 547) for younger (n = 245) and older (n = 302) age groups using structural equation modeling. Findings showed that diaphanous body image had a direct and positive influence on negative food attitudes, which is likely to lead to higher BMI for both age groups. Body image beliefs were positively related to physical activity only for women aged 56–70 years. In contrast, among women aged 40–55 years, strong pro-environmental concerns suggested less consumption of both healthy (e.g., fruit and vegetables) and unhealthy (e.g., sugar and fats) foods. Moreover, strong pro-animal concerns resulted in higher BMI for the younger women. As expected, increased physical activity negatively influenced BMI. Importantly, the associations between ideological beliefs, attitudes, evening meal patterns, and BMI differed between younger and older female baby boomers.

Association between changes in habitual physical activity and changes in bone density, muscle strength, and functional performance in elderly men and women

OBJECTIVES: To investigate the long-term effects of habitual physical activity on changes in musculoskeletal health, functional performance, and fracture risk in elderly men and women.

DESIGN: Ten-year prospective population-based study.

SETTING: Malmö-Sjöbo Prospective Study, Sweden.

PARTICIPANTS: Participants were 152 men and 206 women aged 50, 60, 70, and 80 who were followed for 10 years.

MEASUREMENTS: Distal radius bone mineral density (BMD) (single photon absorptiometry), upper limb muscle (grip) strength, balance, gait velocity, occupational and leisure-time activity, and fractures (interview-administered questionnaire) were reassessed after 10 years. Annual changes for all measures were compared between participants with varying habitual physical activity histories at baseline and follow-up: inactive–inactive (n=202), active–inactive (n=47), inactive–active (n=49), and active–active (n=60). Data for men and women were pooled, because there were no sex-by-activity group interactions. To detect possible differences in fracture incidence between the varying habitual activity groups, participants were classified into two activity groups based on their activity classification at baseline and follow-up: inactive:less active versus active:more active.

RESULTS: The annual rate of bone loss was 0.6% per year less in individuals classified as active at both time points than in those classified as inactive at both time points (P<.01). Similar results were observed for balance, but there was no effect of varying habitual activity on changes in muscle strength or gait velocity. There were also no differences in fracture incidence between individuals categorized as active:more active and those categorized as inactive:less active during the follow-up (adjusted hazard ratio=0.90, 95% confidence interval (CI)=0.42–1.90).

CONCLUSION: This study showed that elderly men and women who maintained a habitually active lifestyle over 10 years had lower bone loss and retained better balance than those who remained habitually inactive.

Reducing psychological distress and obesity in Australian farmers by promoting physical activity

Background: Studies have confirmed that the rate of mental illness is no higher in rural Australians than that of urban Australians. However, the rate of poor mental health outcomes, and in particular suicide, is significantly raised in rural populations. This is thought to be due to lack of early diagnosis, health service access, the distance-decay effect, poor physical health determinants and access to firearms. Research conducted by the National Centre for Farmer Health between 2004 and 2009 reveals that there is a correlation between obesity and psychological distress among the farming community where suicide rates are recognised as high. Chronic stress overstimulates the regulation of the hypothalamic-pituitary-adrenal (HPA) axis that is associated with abdominal obesity. Increasing physical activity may block negative thoughts, increase social contact, positively influence brain chemistry and improve both physical and mental health. This paper describes the design of the Farming Fit study that aims to identify the effect of physical activity on psychological distress, obesity and health behaviours such as diet patterns and smoking in farm men and women.
Methods/Design: For this quasi-experimental (convenience sample) control-intervention study, overweight (Body Mass Index ≥25 kg/m2) farm men and women will be recruited from Sustainable Farm Families™ (SFF) programs held across Victoria, Australia. Baseline demographic data, health data, depression anxiety stress scale (DASS) scores, dietary information, physical activity data, anthropometric data, blood pressure and biochemical analysis of plasma and salivary cortisol levels will be collected. The intervention group will receive an exercise program and regular phone coaching in order to increase their physical activity. Analysis will evaluate the impact of the intervention by longitudinal data (baseline and post intervention) comparison of intervention and control groups.
Discussion: This study is designed to examine the effect of physical activity on psychological health and other comorbidities such as obesity, impaired glucose tolerance, hypertension and dyslipidaemia within a high-risk cohort. The outcomes of this research will be relevant to further research and service delivery programs, in particular those tailored to rural communities.