Physical Activity Diary Research Articles

National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016): Protocol for Design and Development.

BackgroundThe assessment of food consumption data using harmonized methodologies at the European level is fundamental to support the development of public policies. Portugal is one of the countries with the most outdated information on individual food consumption.ObjectiveThe objective of this study was to describe the design and methodology of the National Food, Nutrition and Physical Activity Survey, 2015-2016, developed to collect national and regional data on dietary habits, physical activity (PA), and nutritional status, in a representative sample of the Portuguese general population (3 months-84 years).MethodsParticipants were selected by multistage sampling, using the National Heath Registry as the sampling frame. Data collection, during 12 months, was harmonized according to European guidelines (EU-MENU, European Food Safety Authority [EFSA]). Computer-assisted personal interviewing (CAPI) was performed on a specific electronic platform synchronized with nutritional composition data and considering the FoodEx2 classification system. Dietary assessment was performed using 24-hour recalls (two nonconsecutive, 8-15 days apart) or food diaries in the case of children aged <10 years, complemented with a food propensity questionnaire; PA data (International Physical Activity Questionnaire [IPAQ], the Activity Choice Index [ACI], and 4-days PA diaries); sociodemographic data, and other health-related data were also collected.ResultsA sample of 6553 individuals completed the first interview, and 5811 participants completed two dietary assessments. The participation rate among eligible individuals was 33.38% (6553/19,635), considering the first interview, and 29.60% (5811/19,635) for the participants with two completed interviews (about 40% in children and adolescents and 20% in elderly individuals). Results of the survey will be disseminated in national and international scientific journals during 2018-2019.ConclusionsThe survey will assist policy planning and management of national and European health programs on the improvement of nutritional status and risk assessment related to food hazards, and the enhancement of PA. The infrastructures and data driven from this Survey are a solid basis to the development of a future national surveillance system on diet, PA, and other health behaviors reproducible over time.

Relating process evaluation measures to complex intervention outcomes: findings from the PACE-UP primary care pedometer-based walking trial

BackgroundThe PACE-UP trial demonstrated positive effects of a pedometer-based walking intervention on objective physical activity (PA) outcomes at three and 12 months in 45–75-year-old primary care patients, in postal and nurse-supported trial arms compared with controls. We explored associations between process evaluation measures and change in PA outcomes.MethodsThe MRC framework guided process evaluation. Three quantitative measures (nurse session attendance [dose delivered], PA diary completion [fidelity] and pedometer use [fidelity]) were selected as independent variables in multi-level models estimating intervention effectiveness on PA outcomes (changes in step-counts and time in moderate-to-vigorous PA [MVPA] levels in ≥ 10-min bouts).ResultsDose: attending all three nurse sessions compared with 0–2 sessions was associated with an increase in steps/day at three and 12 months of 1197 (95% confidence interval [CI] = 627–1766) and 605 (95% CI = 74–1137), respectively; and MVPA in bouts (min/week) at three and 12 months by 74 (95% CI = 45–103) and 30 (95% CI = 3–57), respectively. Fidelity: postal and nurse groups showed strong positive associations of diary return with steps/day at three months: postal 1458 (95% CI = 854–2061), nurse 873 (95% CI = 190–1555). MVPA in bouts (min/week): postal 64 (95% CI = 33–94), nurse 50 (95% CI = 15–85). At 12 months, only the postal group effects remained statistically significant: steps/day 1114 (95% CI = 538–1689), MVPA 47 (95% CI = 18–75). Regular pedometer use in the postal group only was associated with higher three-month and 12-month steps/day: 1029 (95% CI = 383–1675) and 606 (95% CI = 22–1190), respectively, and with MVPA in bouts at three months: 40 (95% CI = 6–73).ConclusionProcess evaluation measures demonstrated significant associations with PA outcomes at three and 12 months. We cannot infer causality, but the associations between the process measures and PA outcomes suggest that they were important in enabling the trial changes observed and should be considered core components of the PACE-UP nurse and postal interventions. We have shown the MRC framework to be a useful tool for process evaluation of intervention implementation.Trial registrationISRCTN Registry, ISRCTN98538934. Registered on 2 March 2012.

Primary care pedometer-based walking intervention: mixed-methods results from 3 year follow-up of PACE-UP cluster-randomised controlled trial

BackgroundMaintenance of physical activity is important for health, but few trials provide long-term objective data or qualitative evaluation of factors affecting this maintenance. The PACE-UP three-arm (postal, nurse-support, control) primary care cluster-randomised controlled trial recruited 1023 adults aged 45–75 years into a 12 week pedometer-based intervention including a physical activity diary and handbook incorporating behaviour change techniques; controls received usual care. Recruitment was from Sept 1, 2012, to Oct 31, 2013. At 12 months, step-counts increased by around a tenth, and time in moderate-to-vigorous physical activity (MVPA) in bouts by around a third in postal and nurse-supported arms compared with control. Using a mixed-methods approach at 3 year follow-up of the PACE-UP cohort, we aimed to assess whether the intervention effects persisted. MethodsAssessments were done between Oct 1, 2015, and Nov 30, 2016. Mean daily step-counts and total weekly minutes of MVPA in bouts of 10 min or more at 3 years were collected with 7 day GT3X+ accelerometry (Actigraph, Pensacola, FL, USA) for all trial arms. Outcomes were regressed on baseline values to estimate change in treatment groups compared with control. Sensitivity analysis assessed missing data effects. Semi-structured telephone interviews were conducted with 60 participants. Interviews were audio recorded, transcribed, and coded, and thematic analysis was performed. Ethics approval was given by the National Research Ethics Service Committee London (Hampstead). Findings3 year follow-up with accelerometry was 67% (681/1023). Compared with controls, intervention groups maintained higher steps per day (postal 627 additional steps[95% CI 198–1056], p=0·004; nurse 670 [237–1102], p=0·002), and more total weekly minutes of MVPA in bouts (postal 28 [7–49], p=0·009; nurse 24 [3–45], p=0·03). Results were robust to sensitivity analyses. Most interviewees felt that PACE-UP had increased their awareness of their physical activity. Facilitators to physical activity maintenance included self-motivation, social-support, and maintaining good health, with poor health and lack of time as barriers. InterpretationAt 3 year follow-up of PACE-UP, step-counts and bouts of MVPA persisted, with no difference between intervention groups, suggesting that a primary care pedometer intervention, delivered by post or with nurse support, could help address the public health physical inactivity challenge. Major future challenges are how to apply this kind of effective intervention widely in the population and how to transform perceived barriers into facilitators (eg, poor physical health). FundingNational Institute for Health Research Health Technology Assessment Programme (project number HTA 10/32/02).

Validity of the global physical activity questionnaire (GPAQ) in Bangladesh

BackgroundFeasible and cost-effective as well as population specific instruments for monitoring physical activity (PA) levels are needed for the management and prevention of non-communicable diseases. The WHO-endorsed Global Physical Activity Questionnaire (GPAQ) has been widely used in developing countries, but the evidence base for its validity, particularly for rural populations, is still limited. The aim of the study was to validate GPAQ among rural and urban residents in Bangladesh.MethodsA total of 162 healthy participants of both genders aged 18–60 years were recruited from Satia village (n = 97) and Dhaka City (n = 65). Participants were invited to take part in the study and were asked to wear an accelerometer (GT3X) for 7 days, after which they were invited to answer the GPAQ in a face to face interview.ResultsValid accelerometer data (i.e., ≥10 h of wear times over ≥3 days) were received from 155 participants (rural = 94, urban = 61). The mean age was 35 (SD = ±9) years, 55% were females and 19% of the participants had no schooling, which was higher in the rural area (21% vs 17%). The mean ± SD steps/day was 9998 ± 3936 (8658 ± 2788 and 12,063 ± 4534 for rural and urban respectively, p = 0.0001) and the mean ± SD daily moderate-to-vigorous physical activity (MVPA) was 58 ± 30 min (51 ± 26 for rural and 69 ± 34 for the urban, p = 0.001) for accelerometer. In case of GPAQ, rural residents reported significantly higher moderate work related PA (MET-minutes/week: 600 vs. 360 p = 0.02). Spearman correlation coefficients between GPAQ total MVPA MET-min/day and accelerometer MVPA min/day, counts per minute (CPM) or steps counts/day were acceptable for urban residents (rho: 0.46, 0.55 and 0.63, respectively; p < 0.01) but poor for rural residents. The overall correlation between the GPAQ and accelerometer for sitting was low (rho: 0.23; p < 0.001). GPAQ-Accelerometer correlation for MVPA was higher for females (rho: 0.42), ≤35 age group (rho: 0.31) and those with higher education attainment (rho: 0.48). The Bland-Altman plots illustrated bias towards over estimation of GPAQ MVPA with increased activity levels for urban and rural residents.ConclusionGPAQ is an acceptable measure for physical activity surveillance in Bangladesh particularly for urban residents, women and people with high education. Given waist worn accelerometers do not capture the typical PA in rural context, further study using a physical activity diary and a combination of multiple sensors (e.g., wrist, ankle and waist worn accelerometers) to capture all movement is warranted among rural population with purposive sampling of all education levels.

One Size Does Not Fit All: Contextualising Family Physical Activity Using a Write, Draw, Show and Tell Approach.

Understanding family physical activity (PA) behaviour is essential for designing effective family-based PA interventions. However, effective approaches to capture the perceptions and “lived experiences” of families are not yet well established. The aims of the study were to: (1) demonstrate how a “write, draw, show and tell” (WDST) methodological approach can be appropriate to family-based PA research, and (2) present two distinct family case studies to provide insights into the habitual PA behaviour and experiences of a nuclear and single-parent family. Six participants (including two “target” children aged 9–11 years, two mothers and two siblings aged 6–8 years) from two families were purposefully selected to take part in the study, based on their family structure. Participants completed a paper-based PA diary and wore an ActiGraph GT9X accelerometer on their left wrist for up to 10 weekdays and 16 weekend days. A range of WDST tasks were then undertaken by each family to offer contextual insight into their family-based PA. The selected families participated in different levels and modes of PA, and reported contrasting leisure opportunities and experiences. These novel findings encourage researchers to tailor family-based PA intervention programmes to the characteristics of the family.

The Fitbit One Physical Activity Tracker in Men With Prostate Cancer: Validation Study.

BackgroundPhysical activity after cancer diagnosis improves quality of life and may lengthen survival. However, objective data in cancer survivors are limited and no physical activity tracker has been validated for use in this population.ObjectiveThe aim of this study was to validate the Fitbit One’s measures of physical activity over 7 days in free-living men with localized prostate cancer.MethodsWe validated the Fitbit One against the gold-standard ActiGraph GT3X+ accelerometer in 22 prostate cancer survivors under free-living conditions for 7 days. We also compared these devices with the HJ-322U Tri-axis USB Omron pedometer and a physical activity diary. We used descriptive statistics (eg, mean, standard deviation, median, interquartile range) and boxplots to examine the distribution of average daily light, moderate, and vigorous physical activity and steps measured by each device and the diary. We used Pearson and Spearman rank correlation coefficients to compare measures of physical activity and steps between the devices and the diary.ResultsOn average, the men wore the devices for 5.8 days. The mean (SD) moderate-to-vigorous physical activity (MVPA; minutes/day) measured was 100 (48) via Fitbit, 51 (29) via ActiGraph, and 110 (78) via diary. The mean (SD) steps/day was 8724 (3535) via Fitbit, 8024 (3231) via ActiGraph, and 6399 (3476) via pedometer. Activity measures were well correlated between the Fitbit and ActiGraph: 0.85 for MPVA and 0.94 for steps (all P<.001). The Fitbit’s step measurements were well correlated with the pedometer (0.67, P=.001), and the Fitbit’s measure of MVPA was well correlated with self-reported activity in the diary (0.84; P<.001).ConclusionsAmong prostate cancer survivors, the Fitbit One’s activity and step measurements were well correlated with the ActiGraph GT3X+ and Omron pedometer. However, the Fitbit One measured two times more MVPA on average compared with the ActiGraph.

Context matters! sources of variability in weekend physical activity among families: a repeated measures study

BackgroundFamily involvement is an essential component of effective physical activity (PA) interventions in children. However, little is known about the PA levels and characteristics of PA among families. This study used a repeated measures design and multiple data sources to explore the variability and characteristics of weekend PA among families.MethodsFamilies (including a ‘target’ child aged 9–11 years, their primary caregiver(s) and siblings aged 6–8 years) were recruited through primary schools in Liverpool, UK. Participants completed a paper-based PA diary and wore an ActiGraph GT9X accelerometer on their left wrist for up to 16 weekend days. ActiGraph.csv files were analysed using the R-package GGIR version 1.1–4. Mean minutes of moderate-to-vigorous PA (MVPA) for each weekend of measurement were calculated using linear mixed models, and variance components were estimated for participant (inter-individual), weekend of measurement, and residual error (intra-individual). Intraclass correlation coefficients (ICC) were calculated from the proportion of total variance accounted for by inter-individual sources, and used as a measure of reliability. Diary responses were summed to produce frequency counts. To offer contextual insight into weekend PA among family units, demographic, accelerometer, and diary data were combined to form two case studies representative of low and high active families.ResultsTwenty-five participants from 7 families participated, including 7 ‘target’ children (mean age 9.3 ± 1.1 years, 4 boys), 6 siblings (mean age 7.2 ± 0.7 years; 4 boys) and 12 adults (7 mothers and 5 fathers). There was a high degree of variability in target children’s (ICC = 0.55), siblings (ICC = 0.38), and mothers’ MVPA (ICC = 0.58), but not in fathers’ MVPA (ICC = 0.83). Children’s weekend PA was mostly unstructured in nature and undertaken with friends, whereas a greater proportion of parents’ weekend PA was undertaken alone in structured settings. The family case studies demonstrated that in the selected cases MVPA levels and variability across weekends were contingent on mode of PA participation.ConclusionsThese novel findings enhance understanding of the variability and characteristics of weekend PA among family units. The study demonstrates the utility of PA diaries in conjunction with accelerometers to provide understanding of the mode and contexts of out-of-school and family-based PA.

Effect of a Primary Care Walking Intervention with and without Nurse Support on Physical Activity Levels in 45- to 75-Year-Olds: The Pedometer And Consultation Evaluation (PACE-UP) Cluster Randomised Clinical Trial.

BackgroundPedometers can increase walking and moderate-to-vigorous physical activity (MVPA) levels, but their effectiveness with or without support has not been rigorously evaluated. We assessed the effectiveness of a pedometer-based walking intervention in predominantly inactive adults, delivered by post or through primary care nurse-supported physical activity (PA) consultations.Methods and FindingsA parallel three-arm cluster randomised trial was randomised by household, with 12-mo follow-up, in seven London, United Kingdom, primary care practices. Eleven thousand fifteen randomly selected patients aged 45–75 y without PA contraindications were invited. Five hundred forty-eight self-reporting achieving PA guidelines were excluded. One thousand twenty-three people from 922 households were randomised between 2012–2013 to one of the following groups: usual care (n = 338); postal pedometer intervention (n = 339); and nurse-supported pedometer intervention (n = 346). Of these, 956 participants (93%) provided outcome data (usual care n = 323, postal n = 312, nurse-supported n = 321). Both intervention groups received pedometers, 12-wk walking programmes, and PA diaries. The nurse group was offered three PA consultations. Primary and main secondary outcomes were changes from baseline to 12 mo in average daily step-counts and time in MVPA (in ≥10-min bouts), respectively, measured objectively by accelerometry. Only statisticians were masked to group. Analysis was by intention-to-treat. Average baseline daily step-count was 7,479 (standard deviation [s.d.] 2,671), and average time in MVPA bouts was 94 (s.d. 102) min/wk. At 12 mo, mean steps/d, with s.d. in parentheses, were as follows: control 7,246 (2,671); postal 8,010 (2,922); and nurse support 8,131 (3,228). PA increased in both intervention groups compared with the control group; additional steps/d were 642 for postal (95% CI 329–955) and 677 for nurse support (95% CI 365–989); additional MVPA in bouts (min/wk) were 33 for postal (95% CI 17–49) and 35 for nurse support (95% CI 19–51). There were no significant differences between the two interventions at 12 mo. The 10% (1,023/10,467) recruitment rate was a study limitation.ConclusionsA primary care pedometer-based walking intervention in predominantly inactive 45- to 75-y-olds increased step-counts by about one-tenth and time in MVPA in bouts by about one-third. Nurse and postal delivery achieved similar 12-mo PA outcomes. A primary care pedometer intervention delivered by post or with minimal support could help address the public health physical inactivity challenge.Clinical Trial Registrationisrctn.com ISRCTN98538934.

Comparison of Physical Activity Level, Physical Activity Pattern and Energy Expenditure in Male and Female Elementary School Soccer Players using Accelerometer and Physical Activity Diary

Comparison of Physical Activity Level, Physical Activity Pattern and Energy Expenditure in Male and Female Elementary School Soccer Players using Accelerometer and Physical Activity Diary

Nutritional Status and Nutrition Quality in Patients with Non-Alcoholic Fatty Liver Disease.

Non-alcoholic fatty liver disease (NAFLD) is becoming a major health burden with increasing prevalence worldwide due to its close association with the epidemic of obesity. Currently there is no standardized pharmacological treatment, and the only proven effective therapeutic strategy is lifestyle modification, therefore it is important to determine the potential dietary targets for the prevention and treatment of NAFLD. We assessed nutritional status in 30 patients diagnosed with NAFLD using anthropometric parameters, hand grip strength, and lifestyle and dietetic parameters (physical activity, NRS2002 form and three-day food diary). The mean body mass index was 29.62±4.61 kg/m2, yielding 86.67% of obese or overweight patients. Physical activity results indicat-ed poorly active subjects. Excessive energy intake was recorded in 27.78% of patients. The mean in-take of macronutrients was as follows: 15.5% of proteins, 42.3% of carbohydrates and 42.2% of fat, with -deficient micronutrient intake of calcium, magnesium, iron, zinc, and vitamins A, B1 and B2. The -results showed that the quality of nutrition in study subjects was not accordant to current rec-ommendations and that they consumed a high proportion of fat, especially saturated fatty acids, along with low micronutrient intake. The results obtained might point to the importance of unbalanced diet as a contributing factor in NAFLD development.

Niveles de actividad física moderada-vigorosa de adolescentes del municipio de Soria

Las recomendaciones internacionales aconsejan que los niños y jóvenes practiquen como mínimo 60 minutos/día de actividad física moderada-vigorosa (AFMV). Los objetivos de la presente investigación son: 1) conocer el grado de cumplimiento de las recomendaciones de un grupo de 71 alumnos de 1º y 2º de ESO del municipio de Soria; 2) describir la duración y el gasto energético (GE) de práctica de AFMV en función del sexo y la edad de los participantes, del momento del día (mañana y tarde) y del día de la semana (jornada escolar y fin de semana). Para ello se diseñó un estudio epidemiológico conductual de carácter descriptivo, en el que 171 alumnos redactaron un diario de actividad física (AF), previamente diseñado, durante una semana. La muestra seleccionada fue de 71 alumnos. Los datos obtenidos se recogieron en una tabla de Excel, se analizaron en base al recuento del número de minutos/día de AFMV y se compararon las duraciones y GE en AFMV utilizando la prueba T de Student para muestras independientes. Los resultados obtenidos muestran que el 1.4% del alumnado cumple las recomendaciones internacionales, que los chicos obtienen niveles superiores de duración y GE que las chicas y los alumnos de 1º que los de 2º de ESO, en cualquier momento del día y del día de la semana. La principal conclusión del estudio es que existen bajos niveles de cumplimiento de las recomendaciones de práctica de AFMV.

Dietary Intakes of Elite 14- to 19-Year-Old English Academy Rugby Players During a Pre-Season Training Period

Good nutrition is essential for the physical development of adolescent athletes, however data on dietary intakes of adolescent rugby players are lacking. This study quantified and evaluated dietary intake in 87 elite male English academy rugby league (RL) and rugby union (RU) players by age (under 16 (U16) and under 19 (U19) years old) and code (RL and RU). Relationships of intakes with body mass and composition (sum of 8 skinfolds) were also investigated. Using 4-day diet and physical activity diaries, dietary intake was compared with adolescent sports nutrition recommendations and the UK national food guide. Dietary intake did not differ by code, whereas U19s consumed greater energy (3366 ± 658 vs. 2995 ± 774 kcal·day-1), protein (207 ± 49 vs. 150 ± 53 g·day-1) and fluid (4221 ± 1323 vs. 3137 ± 1015 ml·day-1) than U16s. U19s consumed a better quality diet than U16s (greater intakes of fruit and vegetables; 4.4 ± 1.9 vs. 2.8 ± 1.5 servings·day-1; nondairy proteins; 3.9 ± 1.1 vs. 2.9 ± 1.1 servings·day-1) and less fats and sugars (2.0 ± 1. vs. 3.6 ± 2.1 servings·day-1). Protein intake vs. body mass was moderate (r = .46, p < .001), and other relationships were weak. The findings of this study suggest adolescent rugby players consume adequate dietary intakes in relation to current guidelines for energy, macronutrient and fluid intake. Players should improve the quality of their diet by replacing intakes from the fats and sugars food group with healthier choices, while maintaining current energy, and macronutrient intakes.

남자 고등학생의 주중과 주말의 보행수, 신체활동수준, 에너지 소비량 및 에너지 평형 평가

The purpose of this study was to assess the physical activity and energy balance of weekdays and weekend in male high school students. Fifty healthy male high school students participated in this study. Anthropometric data were collected. Physical activity level (PAL) and energy intake for weekdays and weekend were calculated from a physical activity diary and food diary using the 24-hour recall method and interview. The resting metabolic rate (RMR) and estimated energy requirement (EER) were calculated from the prediction equations suggested in 2015 KDRIs. Total energy expenditure (TEE) was calculated by multiplying RMR by PAL. Mean age of subjects was 15.9±0.33 years. The daily pedometer counts were significantly higher in the weekdays (12,837 steps) than in weekend (6,661 steps) (P<0.001). The PAL of the weekdays (1.63±0.17) was significantly higher than that (1.37±0.26) of the weekend (P<0.001). PAL was significantly correlated with pedometer counts on the weekdays (r=0.495) and weekend (r=0.686). The total energy intakes (2,847.2±681.5 kcal) and TEE (3,046.3±437.3 kcal) of weekdays were significantly higher than those of the weekend. The results of this study would be useful to develop nutrition and exercise programs for male high school students on weekdays and weekend, respectively.

Validity of Self-Reported Pedometer Steps per Day in College Students

ABSTRACTThe purpose of this article was to examine the validity of self-reported pedometer steps/day. Forty-seven participants were provided a New Lifestyles NL-2000 (NL-2000; Lees Summit, MO, USA) pedometer and a physical activity (PA) diary for 3 weeks, but not informed of the data-storing capabilities. For weeks 2 and 3, each participant was given a step goal of 3,000 steps/day above week 1 average. A 2 × 3 repeated measures analysis of variance (ANOVA) was used to examine differences between reported steps/day. Bland–Altman plots assessed the mean bias and limits of agreement between reporting methods. Mean self-reported and NL-2000 steps/day were 9,264 ± 3,555 and 8,971 ± 3,590 steps/day (n = 26, p > .05). Mean biases were 216 ± 1,753 (week 1), –506 ± 1,355 (week 2), and –590 ± 1,360 (week 3) steps/day. Negative mean bias values indicate higher self-reported steps/day. Mean steps/day were similar between recording methods, but large differences were observed among individuals, suggesting self-reported steps/day may be valid for PA research at the population level, but not the individual level.

Effects of aerobic exercise on home-based sleep among overweight and obese men with chronic insomnia symptoms: a randomized controlled trial

ObjectiveTo determine the effect of a six-month aerobic exercise program on home-based sleep quality among overweight and obese men with chronic insomnia symptoms. MethodsParticipants were 45 Finnish men (93% had body mass index ≥25) aged 30–65 years, with chronic (≥3 months) insomnia symptoms as classified by the DSM-IV criteria. Participants were randomized into an exercise (n = 24) or control group (n = 21). The exercise group received six-month aerobic exercise intervention with one to five sessions per week of 30–60 minutes duration. The control group was instructed to maintain habitual lifestyle behaviors during the study period. Seven-night home sleep was measured with a piezoelectric bed sensor and sleep diary. Other assessments included the modified Basic Nordic Sleep Questionnaire, a health and behavior questionnaire, physical activity and diet diaries, anthropometry, fat mass, and physical fitness. Analysis of covariance controlling for baseline values, and repeated-measures analysis of variance were implemented for time-by-group comparisons and within-group comparisons, respectively. ResultsAt six months, the exercise group showed reduced objective sleep onset latency (p = 0.010) and lowered frequency of difficulty initiating sleep (p = 0.021) than controls. Although a time-by-group difference was not significant, exercisers showed shorter objective wake after sleep onset (p = 0.004), reduced subjective nocturnal awakenings (p = 0.010), improved objective sleep efficiency (p < 0.001), and improved morning-rated subjective sleep quality (p = 0.042) at six months than baseline. ConclusionsA six-month aerobic exercise can improve sleep, mainly by mitigating difficulty of initiating sleep among overweight and obese men with chronic insomnia symptoms.

Differences in sedentary time and physical activity among mothers and children using a movement-to-music video program in the home environment: a pilot study.

Measured objectively, less than a quarter of adults and under half of preschool children in Finland meet the physical activity recommendations. Moreover, higher sedentary time among parents (such as watching television) is associated with higher sedentary time of their children. The study introduces an intervention based on reducing sedentary behavior among mothers and their children. It utilizes a combination of music and exercise via a motivation-targeting movement-to-music video program in the home environment. Data were collected in summer 2014 from Finland’s Pirkanmaa region. Each mother–child pair (n = 24, child age: 4–7 years) was assigned to the intervention and control group. Both groups used an accelerometer and completed physical activity diaries for two consecutive weeks (14 days) during waking hours. In addition, the intervention group was instructed to use the movement-to-music video program during the second week. Differences between groups were expected in analysis of sedentary time and physical activity between weeks 1 and 2. The parameters assessed were sedentary time (i.e., lying down or sitting), standing still, and time spent in physical activity. Less sedentary time was revealed in week 2 than in week 1 among both intervention group mothers (56.6 vs. 53.3 %) and for intervention group children (49.5 vs. 46.0 %). The opposite was true of control group mothers (52.1 vs. 52.4 %) and children (46.7 vs. 49.8 %). Within-group differences in mothers’ sedentary time correlated moderately with the children’s sedentary time (Spearman’s r = 0.56). All groups exhibited slightly more standing in the second week than in week 1. Both sets of intervention participants also engaged in more light physical activity in week 2, with the opposite evident for the two control sets. In all groups, except the control children, the proportion of moderate to vigorous physical activity was higher in the second week than the first. The use of music and video content together may yield added benefits in efforts to reduce sedentary behavior and increase physical activity among mothers and their children in the home environment.

Prevalence of Low Energy Availability in Collegiate Female Runners and Implementation of Nutrition Education Intervention

Objective: This study examined the prevalence of low energy availability in a sample of female collegiate athletes (N=25) then delivered nutrition education related to the female athlete triad and assessed change in knowledge and dietary behaviors. Methods: Average energy intake was assessed pre- and post-education using Automated Self-Administered 24- Hour Dietary Recalls. We assessed body composition with multiple-site skinfold measures. Energy expenditure was assessed with accelerometers and a physical activity diary over a 3-day period. A 73-item questionnaire was used to assess knowledge and behavior changes. Results: At baseline, 92% had an index of energy availability <45 kcal/kg of fat free mass/day. 40% of participants were amenorrheic, and 32% had a history of stress fractures. There was an increase in summed nutrition knowledge, post-nutrition education (p=0.001), but no increase in caloric intake (p=0.979). Conclusion: Low energy availability was common in this sample of female collegiate track athletes, but did not improve with a targeted intervention.

Methodology of the My Body is Fit and Fabulous at Home (MyBFF@home): An Intervention Study to Combat Obesity Among Housewives in Malaysia

Introduction: The National Health and Morbidity Survey Malaysia (NHMS 2011) finding showed that female adults (including housewives) are one of the high risk groups that require specific obesity intervention. This paper describes the development and methodology of the My Body is Fit and Fabulous at home (MyBFF@ home), an intervention study to combat obesity among housewives. Methods: The MyBFF@home was conducted in 2 phases and involved mixed quantitative and qualitative methods. Phase I (development of the intervention package) included scoping review, construction and development of initial package, in-depth interviews and, consultations with experts and stakeholders. Phase II (intervention) was a quasi-experimental study which involved pre-post intervention (6 months of weight loss intervention and 6 months of weight sustainability) among 18-59 year old housewives in Klang Valley, Malaysia. Results: Four components were identified for the Intervention Group: individual diet and physical activity (PA) counselling, selfmonitoring tools (food diary and PA diary), group exercise (brisk walking and pillow dumbbell) and a reduced calorie diet. Weight loss was targeted at 5% from the initial weight, and implemented for 6 months of intervention, and another 6 months of weight sustainability. Monitoring of anthropometric, cardiometabolic parameters, body composition, dietary intake, PA, body pain, quality of life, symptoms related to weight loss and health literacy were included. The Control Group was involved in series of women’s seminar and the self-monitoring tools. A total of 328 housewives were recruited from 14 low cost flats. Conclusion: MyBFF@home weight loss intervention for housewives was developed in a systematic manner. The methodology utilised local and international guidelines on the obesity management and it provides evidence on the community-based weight loss intervention among adult females in Malaysia. The package can be modified and adapted to the current weight loss programme to combat obesity among the Malaysian population.

Motive8! Feasibility of a Text Messaging Intervention to Promote Physical Activity in Knee Osteoarthritis

Aim: To develop and test the feasibility of using a SMS text messaging intervention to promote physical activity in patients with knee OA. Methods: 27 people (6 male, 21 female; aged 25-81 years) with knee osteoarthritis received 4 text messages per week, for 6 weeks. Telephone surveys were conducted at baseline and 6 weeks to measure physical activity levels and beliefs, including self-efficacy for exercise, barriers and benefits of exercise, social support and pain. Participants completed physical activity diaries. Process evaluation included participant perceptions of the intervention and 'real-time' data on intervention fidelity (automated collection of delivery and response data) and participant engagement (text response). Results: 648 messages were sent, 100% were accurately delivered. From baseline to 6 weeks, physical activity, self-efficacy for exercise, perceived benefits of exercise and social support significantly increased; reductions were observed in barriers to exercise and pain. Participants engaged with the intervention; 100% read the messages, 89% responded to texts requesting replies, 64% completed physical activity diaries with low attenuation (1.8% drop) by six weeks. Participants perceived messaging to be enjoyable (96%), personally relevant (85%), of appropriate frequency (100%) and duration (88%). Mobile phones, email and web were perceived to be most acceptable for health promotion compared with other forms of technology. Conclusions: People with knee osteoarthritis can engage meaningfully with an interactive mobile phone messaging intervention over a six-week period. Health communications promoting physical activity demonstrate potential for behaviour change and positive implications for perceptions of exercise and pain; this needs to be tested in a randomised trial. Data collected in 'real-time' can be used for process evaluation to demonstrate participant engagement and intervention fidelity.

A primary care pedometer-based walking intervention with and without practice nurse support: PACE-UP cluster-randomised controlled trial

BackgroundWHO guidelines recommend walking to increase moderate-to-vigorous physical activity. Pedometer-based interventions have focused on step-counts, not moderate-to-vigorous physical activity, and have not distinguished between pedometer and support effects. We assessed whether a postal pedometer-based walking intervention could increase step-counts and moderate-to-vigorous physical activity in inactive adults and whether physical activity consultations delivered by a practice nurse could add benefit. Methods11 015 men and women aged 45–75 years, randomly selected from seven family practices in London, UK, with no physical activity contraindications, were invited by post to participate in a parallel three-arm cluster-randomised trial. Randomisation was by household, stratified by practice, using random-sized blocks. 6399 were non-responders; 548 repondents who self-reported achievement of physical activity guidelines were excluded. 1023 people (922 households) were randomised after consent to usual care (338), postal pedometer intervention (339), or nurse-supported pedometer intervention (346). Intervention groups received pedometers, 12 week walking programmes, and physical activity diaries. The nurse group was offered three physical activity consultations. Assessors were unmasked to group for pragmatic reasons. The primary and main secondary outcomes were, respectively, changes from baseline to 12 months in average daily step-counts and time in moderate-to-vigorous physical activity in bouts (≥10 min), measured over 7 days objectively by accelerometry. Analysis accounted for clustering, was by intention to treat, and was masked to group for main outcomes. Ethics approval was granted by the London Research Ethics Committee (Hampstead). This trial is registered with Current Controlled Trials, ISRCTN98538934. FindingsRecruitment rate was 10% (1023/10 467). 955 participants (93%) provided 12 month outcome data. Baseline mean number of step-counts and time in moderate-to-vigorous physical activity in bouts for those randomised were 7479 steps per day (SD 2671) and 94 min/week (102), respectively. Both intervention groups significantly increased number of step-counts and time in moderate-to-vigorous physical activity in bouts compared with controls, with no significant differences between interventions: postal intervention 641 additional steps per day (95% CI 328–954), nurse-support 682 (371–994); postal intervention 33 min/week of additional bouts of moderate-to-vigorous physical activity (17–49), nurse-support 35 (19–51). InterpretationA primary care pedometer-based walking intervention in inactive 45–75-year-olds increased step-counts by about a tenth and increased time in moderate-to-vigorous physical activity in bouts by a third. There was no evidence that nurse delivery had a greater effect on 12 month physical activity outcomes than simpler, resource-efficient postal delivery. A primary care postal pedometer intervention could help address the challenge of public health physical inactivity. FundingNational Institute for Health Research Health (NIHR) Technology Assessment (HTA) Programme (project number HTA 10/32/02). This project will be published in full in Health Technology Assessment. The funding body was not involved in the study design, collection, analysis, and interpretation of data, writing of the abstract, or the decision to submit for publication.