Physical Activity Survey Research Articles

Energy intake misreport: how different methods affect its prevalence and nutrient intake estimates

Background Although different methods for the evaluation of energy intake (EI) misreport have been described, it is unclear which one is the most appropriate. Aim To assess the performance of these methods in the prevalence of EI misreports and accuracy of nutrient intake estimates. Methods Reports of 3,639 adults from the Portuguese National Food, Nutrition and Physical Activity Survey 2015–2016 were classified using univariate (Willett; interquartile range) and multivariate (Goldberg; predicted total energy expenditure [pTEE], testing different standard deviations [SD]) methods. Self-reported intakes were compared to their respective estimates by urinary excretion in a sub-sample of 80. The effect of the exclusion of misreporters on nutrient estimates was assessed by the differences in linear regression coefficients between plausible and total sample. Results The highest prevalence of EI misreport was observed using pTEE 1SD (63.9%). Differences in the associations between nutrient self-reported intake and estimated intake using urinary biomarkers were verified with misreporters’ exclusion by pTEE 1SD method (β-protein = 0.209; 95% CI = 0.074–0.529; β-potassium = 0.276; 95% CI = 0.060–0.560) and Goldberg 2SD (β-protein = 0.080; 95% CI = 0.025–0.235; β-potassium = 0.106; 95% CI = −0.048–0.246). Conclusions Multivariate methods lead to a higher prevalence of misreports and larger differences in nutrient estimates. The application of the pTEE 1SD and Goldberg 2SD methods resulted in more accurate nutrient estimates.

Protocol for GET FIT Prostate: a randomized, controlled trial of group exercise training for fall prevention and functional improvements during and after treatment for prostate cancer

BackgroundMany prostate cancer survivors are treated with androgen deprivation therapy (ADT), but these therapies may increase frailty, worsen physical functioning, and increase fall risk. While exercise may counter functional declines associated with ADT, no studies have tested whether and which type of exercise may reduce falls and frailty. The purpose of this trial is to compare the relative efficacy of strength training versus tai ji quan training against each other and to a stretching control group on falls, frailty, and physical functioning in men expose to ADT for prostate cancer.MethodsProstate cancer survivors treated with ADT (N = 360) who have fallen in the past year or are at risk of a fall based on validated risk factors will be recruited to participate in this single-blind, parallel group, randomized trial. Participants will be randomized to one of three supervised, group training programs: (i) strength training, (ii) tai ji quan training, or (iii) stretching (control), that train 3×/week for 6 months. Outcomes are assessed at baseline, 3 (mid-intervention), 6 (immediately post-intervention), and 12 (follow-up) months. The primary outcome is falls assessed by monthly self-report. Secondary outcomes include the following: frailty (low lean body mass (by bioelectrical impedance analysis), exhaustion (by SF-36 vitality scale), low activity (by CHAMPS physical activity survey), slowness (by 4 m usual walk speed), and weakness (by chair stand time)); objective and subjective measures of physical function will also be collected. Negative binomial regression models will be used to assess differences in falls between groups, while mixed effects modeling will be used to compare the relative efficacy of training group on secondary outcomes.DiscussionExercise represents a non-pharmacologic approach to mitigate the problem of falls experienced among men treated with ADT. By engaging in appropriate exercise, men may be able to avoid or delay falls, frailty, and disability associated with their cancer treatment. Findings of the trial are expected to inform clinical practice about how exercise could be prescribed as part of cancer care for prostate cancer survivors prescribed ADT.Trial registrationClinicalTrials.gov NCT03741335. Registered on November 18, 2018.

Surveillance of Meeting the Youth Physical Activity Guideline: Impact of Including Vigorous-Intensity and Bone-Strengthening Activities

ABSTRACT Purpose: The US youth physical activity guideline recommends participation in four types of physical activity: moderate-to-vigorous intensity aerobic (MVPA), vigorous-intensity aerobic (VPA), muscle-strengthening, and bone-strengthening physical activity. Current national prevalence estimates of meeting the youth physical activity guideline are typically based on measures of the MVPA and muscle-strengthening components. This study sought to examine differences in prevalence estimates using this current approach and then including measures of all four components. Methods: Data from US high school student respondents to the 2010 National Youth Physical Activity and Nutrition Survey were analyzed (n = 10,596). Prevalence of students meeting the youth physical activity guideline were assessed and compared using 1) measures of MVPA and muscle-strengthening components only and 2) also including measures of the VPA and bone-strengthening components. Results: Overall, 15.2% students met the MVPA, 50.7% met the muscle-strengthening, 70.6% met the VPA, and 80.7% met the bone-strengthening components. In total, 12.1% (95% confidence interval: 10.9, 13.3) of students met both the MVPA and muscle-strengthening components, and 11.2% (95% confidence interval: 10.0, 12.4) met all four components. Conclusions: Incorporating additional measures of VPA and bone-strengthening activity into current surveillance systems may not meaningfully impact national estimates of meeting the youth physical activity guideline.

Dietary Patterns in Portuguese Children and Adolescent Population: The UPPER Project.

Considering the nature, extent, and purpose of food processing, this study aims to identify dietary patterns (DPs) and their associations with sociodemographic factors and diet quality in Portuguese children and adolescents. Cross-sectional data were obtained from the National Food, Nutrition and Physical Activity Survey (2015–2016) of the Portuguese population. Dietary intake was obtained from two non-consecutive days and food items were classified according to the NOVA system. The proportion (in grams) of foods in the total daily diet was considered to identify DPs by latent class analysis, with age and sex as concomitant variables. Associations of DPs with sociodemographic characteristics were assessed using multinomial logistic regression. Linear regressions adjusted by sociodemographic characteristics tested associations of DPs with diet quality. DPs identified were: “Unhealthy” (higher sugar-sweetened beverages, industrial breads, and sausages intake), “Traditional” (higher vegetables, fish, olive oil, breads, ultra-processed yogurts, and sausages intake), and “Dairy” (higher intake of milk, yogurt, and milk-based beverages). “Unhealthy” was associated with older ages and lower intake of dietary fibre and vitamins and the highest free sugars and ultra-processed foods (UPF), although all DPs presented significant consumption of UPF. These findings should be considered for the design of food-based interventions and school-feeding policies in Portugal.

Do Older Women of Reproductive Age Have Better Diet Quality than Younger Women of Reproductive Age?

There is increasing recognition of the importance of nutrition for reproductive health, but little is known regarding the diet quality of younger vs. older reproductive aged women, and how their intakes relate to dietary recommendations. The purpose of the study was to examine the diets of younger (19–35 years old) compared to older (35–50 years old) reproductive aged women, and how they align with dietary recommendations. Women aged 19–50 years from the 2011–13 Australian National Nutrition and Physical Activity Survey were included (n = 2323). Dietary intakes were assessed by a single 24-h dietary recall and were compared to (i) Australian Dietary Guidelines; (ii) Acceptable Macronutrient Distribution for protein, carbohydrates, and fat; and (iii) Dietary Guideline Index (DGI). Regression analyses comparing younger and older women against recommendations were undertaken, with confounders determined a priori. There was no difference between older and younger women in meeting food group recommendations, with 26% of all women meeting recommendations for fruit, and meat and alternatives, and <20% meeting recommendations for vegetables and alternatives, grains, and dairy. Although there was no difference between older and younger women in total DGI score (mean (SE) 75.6 (1.7) vs. 74.5 (2.5), p > 0.05), older women had higher component scores in limiting saturated fat, consuming low-fat milk, and limiting adding salt during cooking. Continued health promotion for women of reproductive age should be a key priority to improve their own health and that of future generations.

Health and economic impact of a food substitution in the Portuguese diet: methodology overview

Abstract The Portuguese Food Based Dietary Guidelines (FBDG), namely Food Wheel Guide, as well as the National Food, Nutrition and Physical Activity Survey 2015-2016, advise the Portuguese population to substitute animal protein for vegetable protein. At the same time, 10,1% of the Portuguese families suffered from food insecurity issues, mainly due to lack of financial resources. This study will be the first to investigate the possibilities of associating the health impacts of different risks and benefits through a Risk-Benefit Assessment (RBA) with different methodologies that estimate the economic sustainability of substituting unprocessed red meat by legumes produced in Portugal, e.g. beans and chickpeas in the Portuguese population. An overview of the current Portuguese diet as well as a literature review of the RBA methodology was performed, with specific reference to substitution studies, as means of promoting healthy and sustainable diets. For a socio-economic analysis, relevant literature of specific authorities (FAO, EFSA, ECDC), and published studies (Public Health and Environment institutes), was evaluated and the different methodologies, such as the Willingness To Pay (WTP), behavioral economics and a cost analysis were compared amongst them as to their advantages and disadvantages. From the literature review it can be concluded that not only income or food prices are the only factors that explain food choices. However, if healthier diets are proved to be unaffordable for many people's households, especially the Portuguese families, then nutrient adequate consumption dietary patterns will not improve, even in their lowest prices form, with nutrition education and behavioral change. This way, associating a RBA with a cost analysis is a valuable approach to evaluate the health impact in relation to the cost of substituting red meat for legumes in a household, giving estimates that support policies that promote nutritious foods for all. Key messages Advocate for the substitution of red meat for legumes in the Portuguese population, expected to be both more environmentally-friendly and healthier. Investigate the costs (affordability) of this substitution in the Portuguese households while advocating for healthier foods: methodological overview.

Fortification of grain foods and NOVA: the potential for altered nutrient intakes while avoiding ultra-processed foods.

NOVA is a food classification system describing a hierarchy from minimally processed to ultra-processed foods (UPF). Research has associated intake of UPF with chronic diseases. In Australia, the primary sources of grains, both refined and whole, are breads and breakfast cereals, which are typically fortified. Most are classified as UPF, yet are recommended core foods according to the Australian Dietary Guidelines (ADG). This research aimed to identify if avoidance of ultra-processed grain foods would alter nutrient intakes in an Australian population and whether sample diets using substitute (non-UPF) foods would be likely to meet nutrient requirements. Quantitative analysis of usual nutrient intake from the National Nutrition and Physical Activity Survey 2011-12 (n = 12,153) for all foods including and excluding UPF. Dietary modelling examined the nutritional adequacy of sample diets aligned with the ADG and another containing replacements for UPF. We particularly focused on grain foods and meeting whole-grain intake targets. There was a significant decrease (all p < 0.05) in modelled intake of key nutrients when UPF were excluded, specifically, thiamin, folate and iodine, as substitutions are rarely fortified. Diets with no UPF, where substitutes are carefully chosen, have the potential to meet Nutrient Reference Values, but deviation from customary food choices may mean adoption of substitutes is unlikely. Exclusion of UPF may result in lowered intakes of key nutrients of particular concern for at risk groups (including women of child-bearing age), negating gains made by public health policy of fortification. Substitutions may not be realistic in these at-risk populations.

Interaction effects of socio-economic position in the association between eating location and diet quality in Portuguese children and adolescents: results from the National Food, Nutrition and Physical Activity Survey 2015-2016.

This study aims to evaluate the interaction effect of socio-economic environment (SEE) in the relationship between the eating location (EL) and diet quality, in children and adolescents. Data included Portuguese children and adolescents (3-17 years) from a National Dietary Survey Sample (IAN-AF 2015/2016, n 987). Dietary intake was obtained by 2-d food diaries (children) or 2-24-h-recall (adolescents). Participants were classified into four groups of EL: 'Home', 'Other homes', 'School' and 'Restaurants'. Diet quality was measured as a higher adherence to a healthy eating pattern. A previous developed socio-economic classification was used, and participants were grouped as belonging to a low socio-economic environment (LSE) or middle-high socio-economic environment (MHSE). Linear regression models were used to evaluate the association between EL and diet quality, stratified by the SEE. A statistically significant interaction effect was found (P < 0·01) for the SEE in the association between EL and diet quality. After adjustment for potential confounders, in LSE, participants belonging to 'Other homes' (β = -2·07; 95 % CI:-3·70, -0·44) and 'Restaurants' (β = -3·31; 95 % CI: -5·08, -1·54) had lower scores in the diet quality score, comparing to 'Home'. In MHSE, comparing with 'Home', 'Restaurants' showed lower diet quality (β = -1·56; 95 % CI:-2·65, -0·48), while the 'School' had better diet quality (β = 0·90; 95 % CI: 0·16, 1·64). The SEE influences the association between EL and diet quality and, belonging to more disadvantaged SEE, might represent a higher risk of unhealthy eating habits when eating out-of-home.

Consumption of avocado and associations with nutrient, food and anthropometric measures in a representative survey of Australians: a secondary analysis of the 2011-2012 National Nutrition and Physical Activity Survey.

Avocados are a rich source of nutrients including monounsaturated fats, dietary fibre, potassium and Mg, as well as phytochemicals. However, no epidemiological analysis for the associations between avocado consumption and participant anthropometric measures has been conducted in Australia. The present study aimed to perform a secondary analysis of the 2011-2012 National Nutrition and Physical Activity Survey (NNPAS) to quantify avocado consumption in the Australian population and explore the associations between avocado intakes, consumption of nutrients and food groups based on the Australian Dietary Guidelines and anthropometric measurements. Usual avocado consumption in the 2011-2012, NNPAS was determined using the multiple source method regression model. The relationship between avocado consumption and intakes of key nutrients and food groups and participant weight, BMI and waist circumference were examined using linear regression. Mean avocado intake was 2·56 (95 % CI: 2·37, 2·75) grams per day with 15·9 % of Australians considered to be 'avocado consumers' (n 21526456 population size; n 12153 observations). Greater consumption (g) of avocados was associated with significantly higher consumption of monounsaturated fats, polyunsaturated fats, dietary fibre, vitamin E, Mg and potassium, as well as 'whole grains', 'vegetables', 'fruit' and 'meat and alternatives' food groups. Greater consumption (g) of avocados was associated with significantly lower consumption of carbohydrates and discretionary foods. When adjusted for covariates, greater consumption of avocados was significantly associated with a lower body weight (P = 0·034), BMI (P < 0·001) and waist circumference (P < 0·001). Avocados may be incorporated into an eating pattern and may be beneficial in weight management.

The association between physical fitness, sports club participation and body mass index on health-related quality of life in primary school children from a socioeconomically deprived area of England

We examined associations between physical fitness components, body mass index (BMI) and sports club participation on health-related quality of life (HRQoL) in 8- to 11-year-old children from a socioeconomically deprived region of England. From May-October 2019, 432 children completed the HRQoL questionnaire Kidscreen-27 and Leisure Time Physical Activity Survey, and a physical fitness testing battery of 20 m shuttle run test (20mSRT), handgrip strength (Handgrip), standing broad jump (Broad Jump), and sit-and-reach. Height, body mass, BMI and somatic maturity data were collected. Comparisons with reference populations were undertaken using a quintile framework. Linear and quantile regression assessed associations between physical fitness components and HRQoL variables. Using English Indices of Multiple Deprivation, 90% of children were from the most deprived quintile and 39% were overweight or obese. More children scored poorly on the Physical Wellbeing (40%) and Psychological Wellbeing (45%) HRQoL domains than the reference population (31%). Physical fitness scores were generally classed as ‘low’-’very low’ (42–58%). 20mSRT and Broad Jump performance explained an additional 10.7% of variance in Physical Wellbeing after adjusting for BMI z-score, sex and age (total R2 21.2%). Quantile regression identified a subset of children who rated Physical Wellbeing as high regardless of 20mSRT performance. Sports club participation was associated with better 20mSRT and Broad Jump performance, and all domains of HRQoL. Our data indicate that some physical fitness components and sports club participation are positively associated with HRQoL of children from socioeconomically deprived areas, irrespective of BMI z-score. Interventions to improve HRQoL should consider both aspects.

The food and nutrient intake of 5- to 12-year-old Australian children during school hours: a secondary analysis of the 2011-2012 National Nutrition and Physical Activity Survey.

School food intake of Australian children is not comprehensively described in literature, with limited temporal, nationally representative data. Greater understanding of intake at school can inform school-based nutrition promotion. This study aimed to describe the dietary intake of primary-aged children during school hours and its contribution to daily intake. This secondary analysis used nationally representative, cross-sectional data from the 2011 to 2012 National Nutrition and Physical Activity Survey. Dietary intake was assessed using validated 24-h dietary recalls on school days. Descriptive statistics were undertaken to determine energy, nutrients, food groups and food products consumed during school hours, as well as their contributions to total daily intake. Associations between school food intake and socio-demographic characteristics were explored. Australia. Seven hundred and ninety-five children aged 5-12 years. Children consumed 37 % of their daily energy and 31-43 % of select nutrient intake during school hours, with discretionary choices contributing 44 % of school energy intake. Most children consumed less than one serve of vegetables, meat and alternatives or milk and alternatives during school hours. Commonly consumed products were discretionary choices (34 %, including biscuits, processed meat), bread (17 %) and fruit (12 %). There were limited associations with socio-economic position variables, apart from child age. Children's diets were not aligned with national recommendations, with school food characterised by high intake of discretionary choices. These findings are consistent with previous Australian evidence and support transformation of the Australian school food system to better align school food consumption with recommendations.

1431Dietary patterns and diet quality of Portuguese children and adolescents: the UPPER project

Abstract Background Based on a classification that considers the nature, extent and purpose of food processing, this study aims to identify dietary patterns (DPs) and their associations with diet quality. Methods Sample from the 2015-2016 National Food, Nutrition and Physical Activity Survey (n = 1153;3-17y). Dietary intake from 2 non-consecutive 24h-recalls. Foods classified by NOVA system into 42 subgroups from 4 groups: unprocessed/minimally processed (G1), processed culinary ingredients (G2), processed (G3) and ultra-processed (UPF) (G4). Percentage of grams related to total daily grams consumed were considered to identify DPs by latent class analysis. Adjusted linear regressions were performed to test association with nutritional indicators. Results Subjects followed 3 DPs: “Unhealthy” (51%), “Traditional” (36%), and “Dairy” (13%). Consumption in NOVA groups/subgroups differentiated them: “Unhealthy”, high in G4 and low in G1; “Traditional”, high in G1, G2 and G3, but also some subgroups from G4; and “Dairy”, high in milk, yogurt and milk-based beverages from G1 or G4 and low in most G3 subgroups. Energy from UPF represented 39% in “Unhealthy” and 34-35% in “Traditional” and “Dairy”. Compared to “Traditional” DP, “Unhealthy” was higher in free sugars, and lower in fibre, vitamin A, vitamin C, folates, sodium, potassium, magnesium, and iron. “Dairy” had lower total energy, energy density, fats and sodium, and higher carbohydrates, potassium, calcium, phosphorus and magnesium. Conclusions “Unhealthy” had the worst nutrient profile, although all DPs presented significant consumption of UPF. This should be considered in food-based interventions and school-feeding policies. Key messages Half of Portuguese &amp;lt;18 years presented an “Unhealthy” DP.

1243Quantitative risk-benefit assessment of fish and seafood consumption scenarios to support recommendations

Abstract Background Fish/seafood consumption has health benefits, namely due to its omega-3 fatty acids levels and risks due to methylmercury contamination. This study aims to quantify the health impact of hypothetical scenarios of fish/seafood consumption through a risk-benefit assessment and provide support for recommendations, using Portuguese food consumption data. Methods We used data from the National Food, Nutrition and Physical Activity Survey 2015-2016 (n = 5811) to estimate the mean exposure to methylmercury and EPA+DHA in the current and alternative scenarios. Alternative scenarios were modelled using probabilistic approaches to reflect substitutions from the current consumption in the type of fish/seafood (predatory vs low-mercury species) or its frequency (1-7x/week). The overall scenarios’ impact was quantified using Disability-Adjusted Life Years (DALYs). Results About 14% of the Portuguese population exceeds the methylmercury tolerable weekly intake, and this prevalence is higher among small children (36.6%). Nevertheless, if the fish/seafood consumption increased to once a day, ≈11450 DALYs could be prevented each year. However, such a scenario would result in higher risk for pregnant women (1398 extra DALYs). Moreover, excluding predatory species consumption resulted in small but significant health gains (-1078 DALYs). Conclusions For the general population, the maximum health gains are obtained by consuming fish/seafood up to 7x/week, but among children and pregnant women, the frequency should be limited to 3-5x/week. All population should preferably choose non-predatory species. Key messages Daily fish consumption results in the highest overall populational health gain, but children and pregnant women need to limit it to 3-5x/week, due to methylmercury exposure.

Racket or Bat Sports: No Association With Thumb-Base Osteoarthritis.

Repetitive joint use is a risk factor for osteoarthritis, which is a leading cause of disability. Sports requiring a racket or bat to perform repetitive high-velocity impacts may increase the risk of thumb-base osteoarthritis. However, this hypothesis remains untested. To determine if a history of participation in racket or bat sports was associated with the prevalence of thumb-base osteoarthritis. Descriptive epidemiologic study. Four US clinical sites associated with the Osteoarthritis Initiative. We recruited 2309 men and women from the community. Eligible participants had dominant-hand radiographic readings, hand symptom assessments, and historical physical activity survey data. A history of exposure to racket or bat sports (badminton, baseball or softball, racketball or squash, table tennis [or ping pong], tennis [doubles], or tennis [singles]) was based on self-reported recall data covering 3 age ranges (12-18, 19-34, and 35-49 years). Prevalent radiographic thumb-base osteoarthritis was defined as Kellgren-Lawrence grade >2 in the first carpometacarpal joint or scaphotrapezoidal joint at the Osteoarthritis Initiative baseline visit. Symptomatic thumb-base osteoarthritis was defined as radiographic osteoarthritis and hand or finger symptoms. Radiographic or symptomatic thumb-base osteoarthritis was present in 355 (34%) and 56 (5%), respectively, of men (total = 1049) and 535 (42%) and 170 (13%), respectively, of women (total = 1260). After adjusting for age, race, and education level, we found no significant associations between a history of any racket or bat sport participation and thumb-base osteoarthritis (radiographic or symptomatic; odds ratios ranged from 0.82 to 1.34). In a community-based cohort, a self-reported history of participation in racket or bat sports was not associated with increased odds of having radiographic or symptomatic thumb-base osteoarthritis in the dominant hand.

Clinical Utility of Wearable Sensors and Patient-Reported Surveys in Patients With Schizophrenia: Noninterventional, Observational Study.

BackgroundRelapse in schizophrenia may be preceded by early warning signs of biological, sensory, and clinical status. Early detection of warning signs may facilitate intervention and prevent relapses.ObjectiveThis study aims to investigate the feasibility of using wearable devices and self-reported technologies to identify symptom exacerbation correlates and relapse in patients with schizophrenia.MethodsIn this observational study, patients with schizophrenia were provided with remote sensing devices to continuously monitor activity (Garmin vivofit) and sleep (Philips Actiwatch), and smartphones were used to record patient-reported outcomes. Clinical assessments of symptoms (Positive and Negative Syndrome Scale and Brief Psychiatric Rating Scale) were performed biweekly, and other clinical scales on symptoms (Clinical Global Impression-Schizophrenia, Calgary Depression Scale), psychosocial functioning, physical activity (Yale Physical Activity Survey), and sleep (Pittsburgh Sleep Quality Index) were assessed every 4 weeks. Patients were observed for 4 months, and correlations between clinical assessments and aggregated device metrics data were assessed using a mixed-effect model. An elastic net model was used to predict the clinical symptoms based on the device features.ResultsOf the 40 patients enrolled, 1 patient relapsed after being stable with evaluable postbaseline data. Weekly patient-reported outcomes were moderately correlated with psychiatric symptoms (Brief Psychiatric Rating Scale total score, r=0.29; Calgary Depression Scale total score, r=0.37; and Positive and Negative Syndrome Scale total score, r=0.3). In the elastic net model, sleep and activity features derived from Philips Actigraph and Garmin vivofit were predictive of the sitting index of the Yale Physical Activity Survey and sleep duration component of the Pittsburgh Sleep Quality Index. On the basis of the combined patient data, a high percentage of data coverage and compliance (>80%) was observed for each device.ConclusionsThis study demonstrated that wearable devices and smartphones could be effectively deployed and potentially used to monitor patients with schizophrenia. Furthermore, metrics-based prediction models can assist in detecting earlier signs of symptom changes. The operational learnings from this study may provide insights to conduct future studies.Trial RegistrationClinicalTrials.gov NCT02224430; https://www.clinicaltrials.gov/ct2/show/NCT02224430

Association of Regular Leisure-Time Physical Activity with Happiness among Middle-Aged and Older Adults in Taiwan.

The aim of the present study was to clarify the relationship between regular LTPA (i.e., 150–300 min of moderate-intensity or 75–150 min of high-intensity physical activity) and happiness among middle-aged and older adults in Taiwan. The cross-sectional study data were obtained from the Taiwan National Physical Activity Survey, a nationally representative survey of the Taiwanese population. A total of 12,687 middle-aged and older adults (45–108 years) were ultimately enrolled in this study. The questionnaire data obtained through this national telephone survey included sociodemographic characteristics, self-reported health status, self-evaluations (comprising height, body weight, and happiness), and zip code of residence. The results suggest a significant positive relationship between regular LTPA and happiness scores; that is, the middle-aged adults who engaged in more LTPA may report higher happiness occurrence than others. This study suggests that regular LTPA is an essential factor influencing happiness. LTPA is an essential form of physical activity that helps middle-aged and older people to relax.

Surveillance of Physical Activity and Sedentary Behavior Among Youth and Adults in the United States: History and Opportunities.

Surveillance is a core function of public health, and approaches to national surveillance of physical activity and sedentary behavior have evolved over the past 2 decades. The purpose of this paper is to provide an overview of surveillance of physical activity and sedentary behavior in the United States over the past 2 decades, along with related challenges and emerging opportunities. The authors reviewed key national surveillance systems for the assessment of physical activity and sedentary behavior among youth and adults in the United States between 2000 and 2019. Over the past 20 years, 8 surveillance systems have assessed physical activity, and 5 of those have assessed sedentary behavior. Three of the 8 originated in nonpublic health agencies. Most systems have assessed physical activity and sedentary behavior via surveys. However, survey questions varied over time within and also across systems, resulting in a wide array of available data. The evolving nature of physical activity surveillance in the United States has resulted in both broad challenges (eg,balancing content with survey space; providing data at the national, state, and local level; adapting traditional physical activity measures and survey designs; and addressing variation across surveillance systems) and related opportunities.

Total water intake by kilogram of body weight: Analysis of the Australian 2011 to 2013 National Nutrition and Physical Activity Survey.

Water is critical for human survival, yet water intake equations may not reflect contemporary populations. This research aims to determine the total water intake of a representative Australian population, per kilogram of body weight (mL/kg) and stratified by age and sex. A secondary analysis of the 2011 to 2013 National Nutrition and Physical Activity Survey (n=10 146) was conducted. Dietary intake from food and beverages was assessed by a 24-hour recall, with respondent's weight objectively measured. Data were descriptively analysed, with multiple linear regressions used to identify the impact of demographic and physiologic factors on total water intake (mL/kg). The median (interquartile range) daily total water intake per kilogram of body weight for children (2-8 years), adolescents (9-18 years) and adults (19+ years) were 77.1 (57.4-100)mL/kg, 40.4 (29.3-53.4)mL/kg and 35.5mL/kg (26.1-47.8), respectively. Increasing height and waist circumference were associated with reduced total water intake, with a change of -1.03 mL/kg (-1.43, -0.618) [coefficient (95% confidence interval)] in children for height and -0.448 mL/kg (-0.484, -0.412) in adults for waist circumference. Similarly, seasonality decreased intake, with greatest reductions in winter [adolescents: -4.11 mL/kg (-6.83, -1.40)]. In comparison, being male, living in rural areas and having a physical occupation were associated with greater intake, by 1.73 mL/kg (0.347, 3.10), 4.74 mL/kg (3.47, 6.00) and 2.82 (trade workers: 1.08, 4.59) in adults, respectively. Total water intake (mL/kg) decreased with age in both sexes. The results highlight possibilities to incorporate other factors into water intake equations to improve their accuracy.

Neighborhood Environment, Active Commute, and Healthy BMI in Adolescents

The prevalence of obesity has become a primary risk factor for adolescents’ health, which is an essential factor in poverty reduction and sustainable development. Physical activity can help adolescents reduce obesity risk and keep a healthy body mass index (BMI). We analyze the 2010 National Youth Physical Activity and Nutrition Survey (NYPANS) for U.S. school students from 9th to 12th grades (aging from 12 to 18). A latent variable analysis explored the relationship between adolescents’ BMI, physical activity, and physical and social environment. We found that Hispanic adolescents have higher BMI because they participate in fewer physical activities. We found that active commuting to school does not provide sufficient physical activity to keep a healthy BMI. The neighborhood environment for physical activity, such as public exercise and recreational center facilities, can reduce BMI but cannot help underweight adolescents increase BMI. Finally, spending too much leisure time on electronic entertainment, such as video games, is a dominating contributor to unhealthy BMI. These research outcomes suggest that providing a physical activity-friendly environment for adolescents, such as the facilities for physical activity in the neighborhood, is critical to a healthy BMI. Interventions that encourage physical activity and reduce leisure time on electronic entertainment to meet physical activity guidelines are also necessary.

Perceived Health, Depression and Psychological Well-Being in Older Adults: Physical Activity and Osteoarticular Disease

Osteoarticular diseases are one of the effects of aging, and they are related to physical, psychological, and social functions. Physical activity seems to slow the start and progression of these kinds of illnesses and presents benefits for psychosocial health. The main aim of the study was to investigate the possible effect of physical activity level (Yale Physical Activity Survey) on quality of life (SF-36 Health Questionnaire), subjective psychological well-being (Psychological Well-being Scale), and depression levels (Geriatric Depression Scale), depending on osteoarticular illness. The sample consisted of 263 Spanish adults aged 65 to 98 years who had high or low physical activity (assessed by YPAS Questionnaire) and osteoarticular disease. Results show that physical activity influences the perceived quality of life, depression levels, and subjective well-being in older adults regardless of osteoarticular disease. The present study suggests the need for promoting physical exercise due to its proven positive impact on older adults’ mental health, entailing a significant reduction in the risks of suffering from a variety of frequent diseases and disorders.