International Journal of Behavioral Nutrition and Physical Activity最新文献

Background: Depression is associated with reduced physical activity (PA), and evidence on the long-term effects of interventions and their potential moderators remains limited. Thus, this study aimed to evaluate the short- (post-intervention) and long-term (six-month follow-up) effects of a PA-promoting intervention on contextual PA and to explore potential moderators in adults with depressive symptoms.

Methods: A randomized, controlled, and assessor-blinded clinical trial was conducted with adults presenting depressive symptoms. The intervention lasted 16 weeks, with two sessions per week. Strategies were grounded in Self-Determination Theory and aimed to increase participants' awareness of their lifestyle, primarily focusing on PA and its relationship with depression. Activities included lectures, group discussions, interactive activities with family and friends, and PA practices in different contexts. Intensity-specific PA was assessed using wrist-worn accelerometers, and contextual PA (by type and domain) was self-reported. Generalized estimating equations were used to assess intervention effects. Potential moderators (sex and age) were examined in exploratory analyses using three-way interaction terms.

Results: A total of 78 individuals (76.9% women, mean age 37.5 ± 10.2) were equally randomized into control (CG) and intervention (IG) groups. No significant group-by-time interactions were identified in the intention-to-treat analyses. However, per-protocol analysis suggested that the intervention increased leisure-time PA compared to controls (p = 0.004), with short-term increases (between-group changes of 119.6 min/week) and maintenance at follow-up (83.6 min/week). Exploratory moderator analyses indicated potential differences in intervention effects according to sex and age.

Conclusion: Although no significant effects were identified in the intention-to-treat analyses, per-protocol findings suggested potential increases in leisure-time PA among participants with higher adherence. Exploratory findings indicate possible variation according to sex and age, but these results should be interpreted with caution and considered hypothesis-generating. Overall, the findings highlight the importance of strategies to improve adherence in PA interventions targeting adults with depressive symptoms.

Trial registration: Brazilian Registry of Clinical Trials (ReBEC) RBR7466htj, April, 17 2023. Retrospectively registered.

Background: Health behaviours such as physical activity, sedentary behaviour, nutrition, sleep, alcohol consumption, and smoking are modifiable determinants of life satisfaction - an essential outcome for healthy ageing and well-being. We explored the longitudinal association between these health behaviours and life satisfaction among older adults in Canada.

Methods: The study was a secondary analysis of data from the Canadian Longitudinal Study on Aging, focusing on 11,215 adults aged 65 years and older at baseline, with follow-ups 1 and 2 at three-year intervals. Data were analysed using linear mixed-effects growth curve models, stratified by gender, with health behaviours decomposed into within- and between-person components.

Results: At baseline, the participants' mean (SD) age was 72.94 (5.64) years, and 54.2% were women. Women had lower life satisfaction than men across waves, but the difference was trivial (B=-0.24, p = 0.035, predicted difference [pd]=-0.24 points, effect size [d]=-0.04). Men showed a decline in life satisfaction over time, though the effect size was small (B=-0.09, p = 0.004, pd=-0.54 points, d=-0.09). Within-person analyses showed that higher alcohol use relative to one's usual pattern was associated with lower life satisfaction (B=-0.23, p = 0.037, pd=-0.92 points, d=-0.15), especially among men, with an appreciable effect size (B=-0.35, p = 0.024, pd=-1.40 points, d=-0.24). In contrast, improvements in nutritional risk (B = 0.04, p < 0.001, pd = 0.24 points, d = 0.04) and sleep duration (B = 0.22, p < 0.001, pd = 0.32 points, d = 0.05) were associated with negligible concurrent increases in life satisfaction. At the between-person level, higher average physical activity across the waves was associated with slightly higher life satisfaction (B = 0.01, p = 0.004, pd = 0.58 points, d = 0.10), particularly among men (B = 0.01, p < 0.001, pd = 0.58 points, d = 0.10), whereas higher average sedentary time was weakly associated with lower life satisfaction (B=-0.04, p < 0.001, pd=-0.33 points, d=-0.06). Lower average nutritional risk (B = 0.20, p < 0.001, pd = 1.22 points, d = 0.21) and higher average sleep duration (B = 0.35, p < 0.001, pd = 0.51 points, d = 0.09) were associated with higher life satisfaction, with nutrition showing a modest effect size.

Conclusions: The findings demonstrate that behavioural changes and sustained health behaviours are associated with differences in older adults' life satisfaction, with gender-specific patterns, providing actionable evidence for individuals, healthcare practitioners, and policymakers to promote healthy behaviours.

Background: (Un)healthy eating behaviours may vary by moment and psychological context. Ecological momentary assessment (EMA) is well-suited to study within-person, momentary, and context-dependent behaviours and correlates, as it uses repeated sampling of real-time experiences. Insights in such within-person relations could inform ecological momentary interventions. A systematic review and meta-analysis of these insights in a healthy population is, however, currently lacking. The aim of this systematic review and meta-analysis was to synthesise within-person associations between psychological factors and eating behaviour in healthy adults, and summarise methodological aspects of these studies.

Methods: Observational and experimental studies on psychological predictors of (un)healthy eating behaviours in adult healthy populations were included, based on a systematic search of Ovid MEDLINE, Embase, PsycINFO and Web of Science. Meta-analysis of ≥ 5 studies per predictor/outcome was performed in metafor R-package.

Results: During title and abstract screening, n = 2046 articles were reviewed (n = 119 from overarching review, n = 1927 from updated search), n = 208 were screened in full-text screening. Forty-nine (review) and fifteen studies (meta-analysis) were included. Most studies were observational, and used fixed time-based sampling, and most assessed food eaten since the last prompt/timeframe. Various measures reported on study adherence (between 79 and 90%). Only around half reported on reliability and/or validity of the predictors or outcomes, most often referring to an adaptation of non-EMA scales, with little information of their exact adaptation. Due to high diversity in conceptualization and reporting of effect sizes, not all could be meta-analyzed. Meta-analyses showed negative psychological triggers (NPT, e.g., negative affect, daily stress, and ruminations) predicted lower levels of healthy eating behaviour (β=-0.007, p=.028, k = 8, n total = 1,489), higher levels of unhealthy eating behaviour (β = 0.054, p=.022, k = 6, n total = 1,578), but had no significant association with unhealthy behaviour event occurrence (logOR=0.469, p=.095, k = 5, n total = 934). All meta-analyses were characterized by small effect sizes and important heterogeneity.

Conclusions: Associations at the within level of NPT with (un)healthy eating highlight their potential utility for inclusion in health promoting ecological momentary interventions. Nevertheless, the methodological and conceptual heterogeneity of the studies highlight a need for harmonized practices, including broader adoption of reporting guidelines, to facilitate cumulative knowledge in the field.

Background: Meeting the 24-Hour Movement Guidelines (24-HMG), comprising aerobic physical activity, sedentary behavior including recreational screen time, and sleep, is critical for post-secondary student health. However, multi-year temporal trends spanning the pandemic and post-pandemic period, as well as sociodemographic and mental health disparities, remain understudied in Canada. This limits the development of targeted interventions.

Methods: We conducted a serial cross-sectional analysis using Canadian Campus Wellbeing Survey data collected between 2019 and 2025. A self-reported questionnaire was administered annually to assess aerobic physical activity, sedentary behavior (including recreational screen time), sleep duration, sociodemographic characteristics, and mental health. Prevalence of meeting individual and integrated 24-HMG components was estimated. Temporal trends were examined using regression models with survey year treated as a continuous variable and were further stratified by sociodemographic characteristics and mental health status. Multivariable logistic regression was used to examine factors associated with meeting all guidelines and meeting none.

Results: Among 116,597 students (mean [SD] age, 23.95[8.02] years; 78,623[67.43%] women), divergent trends emerged. From 2019 to 2025, meeting physical activity and sedentary behavior guidelines increased, whereas meeting recreational screen time and sleep guidelines declined. The proportion meeting none of the guidelines significantly decreased, ranging from 7.45% to 4.44% (-0.29% [-0.30, -0.22], p < 0.001). Meeting all guidelines (14.66% in 2019, 8.92% in 2021, 11.74% in 2025) showed a positive linear trend (β = 0.30% [95% CI: 0.20, 0.40], p < 0.001) that sensitivity analyses attributed to transient COVID-19 fluctuations. Meeting none of the guidelines significantly decreased (β = -0.29% [-0.30, -0.22], p < 0.001). Disparities were observed: younger students (≤ 24 years), those identifying as non-binary/Two-Spirit or Black, those reporting lower parental education or high financial stress, and those experiencing severe mental distress or low well-being were less likely to meet integrated guidelines.

Conclusions: While post-pandemic improvements were observed in physical activity and sedentary time, prevalence of meeting recreational screen time and sleep guidelines declined over time. Overall compliance with all movement components remains low and socially patterned. Continued surveillance and focused, equity-informed campus health strategies are warranted to address persistent behavioral and mental health disparities in the digital era.

Background: Community-supported agriculture (CSA) programs are an evidence-based approach to increase fruit and vegetable (F&V) intake while also strengthening the local farming economy and social bonds. However, uptake has been limited due to payment structures and/or CSA offerings not reflecting local community preferences. To address this need, we developed the Harvest Share program, which centers a cost-offset CSA tailored to local communities in New York City. Here, our objective is to conduct a mixed-methods evaluation of year one of Harvest Share to evaluate its preliminary impact on diet and social outcomes.

Methods: Harvest Share participants (n = 542; n = 153 CSA and n = 389 comparison community [CC] participants) completed surveys and Veggie Meter readings-an objective measure of F&V intake-at the start and end of the 20-week growing season (~ June-October 2023). Qualitative interviews were conducted with n = 23 participants to understand program experiences. Mixed effect linear regression models were used to examine the impact of Harvest Share on primary (Veggie Meter score) and secondary outcomes (diet and social variables). Significant associations were based on the group (CSA vs. CC) by time (pre vs. post) interaction term. Descriptive, thematic analysis was used to analyze interviews.

Results: Across CSA and CC participants, individuals were, on average, 44 years old; female (80%); Asian (48%) or Hispanic/Latino (37%); and of lower socioeconomic status (55% with annual household income <$50,000). Change in Veggie Meter scores (p = 0.02), F&V consumption (p < 0.0001), and F&V knowledge (p = 0.0004) significantly differed between CSA and CC participants. Veggie Meter scores trended downwards in both groups, but the decline was non-significant among CSA participants (CSA: -7.43 [95%CI: -21.30, 6.44]; CC: -27.29 [95%CI: -36.27, -18.30]). CSA participation was associated with an increased number of different types of F&V consumed (CSA: 3.74 [95%CI: 2.94, 4.53]; CC: 0.05 [95%CI: -0.48, 0.57]) and decreased number of F&V that individuals did not know how to prepare (CSA: -1.60 [95%CI: -2.28, -0.93]; CC: -0.13 [95%CI: -0.57, 0.32]). Qualitative interviews indicated the CSA also promoted family and community connection and improved physical and mental health.

Conclusions: A cost-offset, tailored CSA can improve diet and social outcomes using a model that supports farmers.

Trial registration: Registered on ClinicalTrials.gov as NCT05381766 (registration date: May 19, 2022).

Background: Research investigating whether walking promotion programs work equally at different levels of walkability needs to be scaled up. This study examined the associations of neighbourhood walkability attributes with adult participants' withdrawal from an incentive-based walking promotion program, and changes in step counts among non-withdrawing participants.

Methods: We used data from 30,530 participants aged 40-74 years enrolled in an incentive walking program in Yokohama City, Japan, in which uploading step-count data was required to enter a raffle for rewards. The follow-up period was up to 48 months. Withdrawal was defined as not uploading step counts during the last six months of the follow-up. Neighbourhood walkability attributes included population density, intersection density, destination diversity, and their composite measure (the Japan Postcode-level Walkability Index). We fitted multilevel Cox proportional hazards models to examine the associations between walkability attributes and program withdrawal, and mixed-effects models to examine the interaction between walkability attributes and time on step counts.

Results: During the follow-up period (median: 28 months), 62% of participants withdrew from the program. Compared to those living in the lowest intersection density areas, those in areas with the highest, the second-highest, and the third-highest intersection density had 7% (95% CI: 0.88, 0.98), 6% (0.89, 0.99), and 7% (0.89, 0.98) lower hazard ratios of withdrawal from the program, respectively. The third-highest population density areas showed a 5% (1.00, 1.10) higher hazard ratio of withdrawal, relative to the lowest. Step counts, which exceeded 7,000 steps/day during the study period, declined between the first and second years but slightly increased from the second to third year. There were no statistically significant interactions between the neighbourhood walkability attributes and time in relation to changes in step counts.

Conclusion: Living in areas with higher street connectivity was associated with a higher retention in the program, whereas the program showed almost comparable effectiveness regarding changes in step counts for continuing participants living in areas with different levels of walkability. These findings suggest the need for initiatives to support adherence to walking-incentive programs, particularly among those who live in areas with less connected streets.

Background: Frailty is a prevalent geriatric syndrome in older adults, characterized by reduced physiological reserves and increased vulnerability to adverse health outcomes. Physical inactivity is a key modifiable risk factor that accelerates frailty progression. Nudge-based interventions, which subtly guide behavior through choice architecture, offer a promising, low-cost approach to promoting physical activity and improving health outcomes in this population METHODS: A systematic search was conducted in PubMed, EMBASE, Cochrane Library, Web of Science, PsycINFO, and EconLit from inception to May 20, 2025, for randomized controlled trials (RCTs) on nudge-based physical activity interventions in frail older adults. Two reviewers independently performed study selection, data extraction, and quality assessment using the Cochrane risk-of-bias tool. Pooled effect sizes were calculated using random- or fixed-effects models as appropriate, with standardized mean difference (SMD) or mean difference (MD) reported for continuous outcomes. Statistical heterogeneity was assessed using I² and Cochran's Q tests.

Results: A total of 16 studies involving 2,730 participants were included. Meta-analysis indicated that physical activity interventions based on nudge strategies significantly improved depressive symptoms [SMD = - 0.30, 95% CI (- 0.51, - 0.09), P = 0.016], enhanced cognitive function [SMD = 0.47, 95% CI (0.26, 0.69), P = 0.005], increased physical activity levels [SMD = 1.09, 95% CI (0.43, 1.75), P = 0.001], improved gait speed [MD = 0.07, 95% CI (0.03, 0.11), P = 0.001], enhanced quality of life (QoL) [SMD = 1.02, 95% CI (0.09, 1.94), P = 0.031], and reduced frailty scores [SMD = - 2.00, 95% CI (- 3.01, - 1.00), P < 0.001]. Although improvements were observed in self-efficacy, grip strength, balance ability, and Timed Up and Go (TUG) test performance, these differences were not statistically significant (P > 0.05).

Conclusions: Physical activity interventions based on nudge strategies can significantly increase physical activity levels, effectively improve frailty status, depressive symptoms, cognitive function, gait speed, and QoL among frail older adults. These interventions represent a low-cost and highly feasible behavioral approach for promoting healthy aging.

Registration: CRD420251229406.

Background: Developmental coordination disorder (DCD) is a common neurodevelopmental condition in preschoolers. Physical activity (PA) and screen exposure are two highly prevalent and modifiable daily behaviors in early childhood, but evidence regarding their joint association with DCD is limited. This study aimed to investigate the joint associations of PA and screen exposure time (SET) with subsequent suspected DCD in Chinese preschoolers.

Methods: This study used data from a nationally representative, stratified cluster survey covering 551 cities across China. Motor coordination was assessed by the Little Developmental Coordination Disorder Questionnaire (LDCDQ), and suspected DCD was defined according to age- and sex-specific cut-off values. Parent-reported data was used to calculate total daily physical activity (TDPA), moderate-to-vigorous physical activity (MVPA), and daily SET over the previous 12 months. The interactions between PA and SET were examined on both additive and multiplicative scale. Multilevel logistic regression models were employed to explore the association of PA and SET with suspected DCD.

Results: The study included 129,278 preschoolers, among whom 19,969 (15.4%) were suspected DCD. Compared with children in the normal TDPA & SET < 1 h group, the group of low TDPA & SET > 4 h exhibited highest odds of subsequent suspected DCD (aOR = 2.29, 95% CI: 2.02-2.60) when adjusting for covariates; while compared with the normal MVPA & SET < 1 h, those with normal MVPA & SET > 4 h exhibited highest odds of suspected DCD (aOR = 1.96, 95% CI: 1.78-2.15). Analysis of interaction on additive scale (RERI = -0.22, 95% CI: -0.31 to -0.13) and multiplicative scale (aOR = 0.87, 95% CI: 0.80-0.94) indicated that a significantly negative interaction was observed between low MVPA and SET at 1-4 h/day using normal MVPA & SET < 1 h as the reference. Stratified analyses revealed that: (1) low TDPA was a risk factor for suspected DCD at SET ≤ 4 h, whereas low MVPA appeared protective; and (2) across all PA strata, SET ≥ 1 h was significantly associated with the risk of suspected DCD.

Conclusions: Insufficient TDPA, higher MVPA, and excessive SET were associated with a higher risk of subsequent suspected DCD among Chinese preschoolers. A protective interaction was observed between low MVPA and moderate screen exposure (1-4 h/day).