International Journal of Behavioral Nutrition and Physical Activity最新文献

Background: An unhealthy diet, excessive screen time, low levels of physical activity and suboptimal sleep are known risk factors for childhood overweight and obesity (OW/OB). These energy balance-related behaviors tend to co-occur and combine into "lifestyle patterns" (LPs) that may have a synergistic effect on OW/OB. However, few studies have examined these LPs before preschool age, and none investigated the possible involvement of parental feeding practices (e.g., breastfeeding and timing of complementary feeding), non-screen leisure activities and sleep quality. We aimed to identify such LPs during the first 2 years of life and assess their associations with OW/OB at age 5 years and age at adiposity rebound (AR).

Methods: Participants were children from the French nationwide ELFE (Etude Longitudinale Française depuis l'Enfance) birth cohort. We used principal component analysis of 18 items characterizing parental feeding practices and children's energy balance-related behaviors (n = 13,121) to derive LPs. We analyzed the associations of LPs with OW/OB at age 5 years (International Obesity Task Force definition; n = 8,388) and age at AR (in days; n = 7,845) using multivariable logistic and linear regression models, respectively.

Results: We identified three LPs: "Early complementary feeding, discretionary consumption, high screen time", "Balanced diet, non-screen leisure activities", and "Healthy feeding practices, low dairy consumption, suboptimal sleep" patterns. The first pattern was positively associated with OW/OB at age 5 years (OR [95% CI] = 1.09 [1.03, 1.16] per 1-SD increase) and inversely associated with age at AR (β [95% CI] = - 12.1 days [- 19.1; -5.0] per 1-SD increase). No association was observed for the second LP. For the third pattern, no clear evidence of associations was found, although the effect sizes were comparable to those of the first LP (OR = 1.07 [0.99; 1.15]; β = -7.6 days [- 15.5; 0.3] per 1-SD increase).

Conclusion: These results emphasize the perinatal period as a critical window for the emergence of interrelated lifestyle behaviors associated with OW/OB. They highlight the need for interventional studies to evaluate the effectiveness of early, integrated, multi-behavioral strategies to prevent childhood obesity.

Background: Mobility is a cornerstone of healthy ageing typically assessed using self-report and performance-based measures. Recent research suggests these measures are poor proxies for real-world mobility. Device-derived measures of real-world mobility reflect the relative proportions of time a person allocates to sedentary behaviour (SB), light-intensity physical activity (LIPA), and moderate-to-vigorous physical activity (MVPA) that together form the waking-day movement behaviour composition. The aim of this study was to examine the associations between commonly used mobility measures and the waking-day movement behaviour composition in older adults.

Methods: A cross-sectional analysis of data from over 1200 older adults ≥ 65 years of age from the baseline cohort (2022-2024) of the McMaster Monitoring My Mobility (MacM3) study was conducted. Compositional data analysis was used to examine the associations between 6 self-report and 10 performance-based measures of mobility and multiple components of the waking-day movement behaviour composition and establish differences in movement behaviours according to different levels of mobility. Examples of included measures are the Physical Activity Scale for the Elderly (PASE) and Timed Up and Go (TUG).

Results: Data from 1227 older adults (73.6 ± 5.3 years) were analysed. Significant differences in waking-day movement behaviour composition were found across the self-report and performance-based mobility measures. Older adults with lower mobility accumulated more SB and less MVPA throughout the day. For example, those with poorer TUG performance accumulated 34 more minutes/day of SB, and 22 min/day less of MVPA compared to those with better performance. The PASE, 400-meter walk, and fast gait speed tests were the strongest indicators of real-world mobility; however, the effect sizes were small. No measure showed a significant association with LIPA.

Conclusions: Traditional self-report and performance-based measures of mobility are associated with the waking-day movement behaviour composition in older adults; however, their ability to explain real-world mobility is limited and varies across measures. The lack of association between any of the measures and LIPA is surprising, given that older adults spend most of their time in this activity intensity. These findings challenge the widespread use of traditional mobility measures to make inferences about real-world mobility.

Background: College students' prolonged sedentary behavior due to heavy academic burdens impairs cognitive functions and academic performance. Classroom physical activity breaks have been studied in younger students, but evidence among college students remains limited. This study aims to systematically evaluate the effects of classroom physical activity breaks on academic-related outcomes among college students, including classroom engagement, academic emotions, attention, and academic performance.

Methods: A comprehensive literature search was conducted across databases, including PubMed, Web of Science, and ERIC (EBSCOhost), covering all publications up to May 2025, supplemented by manual search and citation tracking.

Results: A total of 5,813 records were initially identified, and 20 studies met the inclusion criteria. Overall, classroom physical activity breaks were positively associated with improvements in sustained attention, emotional engagement, and positive academic emotions. However, findings for selective attention, behavioral engagement, negative emotions, and academic performance were mixed or inconclusive, with several studies reporting non-significant effects and one study reporting a negative effect on selective attention.

Conclusions: Physical activity breaks in the classroom improved students' learning behaviors and may also contribute to enhanced academic outcomes. This study highlights that, provided teaching efficiency is not compromised, the integration of classroom physical activity breaks represents a viable and impactful educational intervention.

Background: Metabolic syndrome (MetS) is a multifactorial condition characterized by obesity, hypertension, hyperglycemia, and dyslipidemia, often resulting from unhealthy lifestyle and behavioral patterns. This study aimed to develop and validate a Healthy Lifestyle and Behavioral Scale (HLBS) that reflects the combined influence of key pillars of lifestyle medicine and to examine its longitudinal association with MetS risk in a large Taiwanese cohort.

Methods: Data were drawn from 201,123 participants of the Mei Jau Health Management Institution between 2000 and 2023. Item selection followed a rigorous construct validation process and selection criteria, including exploratory and confirmatory factor analyses, item response theory modeling, and reliability testing. We then combined the HLBS components such as diet, physical activity, sleep, and substance use, and performed a log binomial generalized estimating equation model to assess its risk association with MetS development.

Results: The HLBS demonstrated acceptable model fit and strong internal consistency. Moderate (RR = 1.12; 95% CI = 1.09-1.16) and low (RR = 1.46; 95% CI = 1.41-1.50) adherence to healthy lifestyle behaviors were associated with an increased risk of developing MetS compared with high adherence, and each HLBS component independently contributed to elevate MetS risk. Stratified analyses showed consistent linear associations across all age and sex groups, with stronger effects observed among adults and the elderly.

Conclusions: The HLBS provides a reliable, culturally adapted tool for assessing lifestyle behaviors and identifying populations at risk for metabolic disorders. These findings emphasize the importance of promoting comprehensive lifestyle interventions to reduce MetS risk in the general population.

Background: Whole-school physical activity (WSPA) approaches are recognised globally as a key investment for increasing children's activity levels. Their success depends on translating national policy into effective school practices through systems-level thinking and multi-stakeholder collaboration. This study aimed to use an experience-based co-design process to produce and prioritise future directions for WSPA policy, practice and research by engaging international stakeholders to identify key roles, needs, and actionable recommendations.

Methods: The co-design process took place during a two-day international conference on Whole-School Physical Activity (#WSPA2024). Adopting a design thinking approach, 152 international stakeholders representing 16 countries engaged in two co-design workshops. Participants included professionals representing the policy (n = 64), practice (n = 26), or research (n = 62) sectors. Participants undertook tasks in either same stakeholder or mixed stakeholder groupings to explore and prioritise future needs for policy, practice, and research related to WSPA. All discussions were audio recorded, transcribed verbatim, and analysed using inductive thematic and content analysis. Prioritised actions were synthesised and recommendations to support the future of WSPA were drafted. Stakeholders reviewed the drafted recommendations and proposed modifications using an online questionnaire.

Results: Twenty-four recommendations (10 for policymakers, eight for practitioners, and six for researchers) to prioritise and plan for WSPA were developed. These are represented by six interlinked themes reflecting conditions for change: systems thinking, partner engagement and collaboration, equity and inclusion, evidence-based and action orientated, knowledge mobilisation, support and capacity building.

Conclusions: WSPA approaches should be viewed as a long-term systems change agenda requiring aligned policy, adaptable practice, and innovative research. The WSPA recommendations provide a platform for multi-sector collaboration, co-production, and investment in scalable, context-sensitive solutions.

Compositional data analysis (CoDA) is widely used to examine the associations between one's balance of movement behaviors (sedentary behavior, physical activity, and sleep) and health outcomes. Existing reviews have primarily focused on reporting standards for physical activity and sedentary behavior, but have not considered the contribution of sleep reporting to our understanding of CoDA.Purpose To characterize device-based sleep data measurement, processing, and reporting in studies using CoDA to examine associations between movement behaviors and health indicators.Methods A systematic search was conducted in seven databases, along with supplemental strategies (forward and backward citation searches and expert review). Observational studies published since 2015 that employed CoDA approaches using isometric log-ratio transformations to examine the associations between movement behavior compositions utilizing device-based measures of sleep and health outcomes were included. Data extraction included items based on sleep actigraphy measurement, processing, and reporting practices recommended by the American Academy of Sleep Medicine. The National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was used to assess study quality.Results Among the 70 included studies (n = 60 cross-sectional, n = 10 longitudinal), few articles reported key sleep measurement and processing information. Most articles (n = 67) included only one sleep component in the time-use composition, and less than half of the articles (n = 29) acknowledged sleep-related limitations. Reports were classified as having good (n = 60) or poor (n = 10) study quality.Conclusions This review identified inconsistencies in the measurement, processing, and reporting of device-measured sleep in studies using CoDA. Varying protocols and reporting on sleep data processing highlight the need for adoption of current standardized approaches and reporting practices. Future research should prioritize transparency and consistency to improve the validity and comparability of findings on sleep's role as a key component of the integrative 24-h approach to health.

Background: Food education has become an important policy priority in Taiwan following the enactment of the Food and Agriculture Education Act. However, empirically validated instruments for assessing food literacy among elementary school students remain limited. This study aimed to develop and validate a Food Education Scale (FES) for measuring food literacy among upper elementary school students in Taiwan.

Methods: The scale was developed based on the six principles of Taiwan's Food and Agriculture Education Act and Nutbeam's (2000) framework of functional, interactive, and critical literacy. A two-dimensional framework integrating food education content and literacy competencies was constructed. Through expert review, pilot testing, and large-scale survey administration, a 36-item questionnaire was finalized. The formal survey included 400 upper elementary students from 12 schools across northern, central, southern, and eastern Taiwan. Reliability and construct validity were assessed using Cronbach's α, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) to demonstrate satisfactory construct, convergent, and discriminant validity.

Results: The results indicated that the FES demonstrated satisfactory psychometric properties. Internal consistency for all dimensions exceeded the recommended threshold (Cronbach's α > 0.70), and both EFA and CFA supported the scale's overall construct validity. In terms of performance patterns, students scored relatively higher in the dimensions related to cherishing food and reducing waste as well as food culture inheritance, while comparatively lower scores were observed in balanced dietary concepts and local production-local consumption. Differences in food literacy were also associated with school types, regional contexts, and family food practices.

Conclusions: The Food Education Scale provides a validated instrument for assessing food literacy among upper elementary school students in Taiwan. The findings provide a validated, policy-aligned instrument for assessing children's food literacy and offer practical guidance for curriculum design and sustainability-oriented food education policies.

Background: Current infant diet recommendations are often not followed by caregivers, impacting their infant's diet quality. Incorporating diet guidelines with real-time feedback via technology may improve infant diet quality, helping mitigate future obesity risk. This study reports the effectiveness of the Baby-Feed website in improving diet quality among US infant caregivers compared to controls. This website was designed using trusted behavior-change theories to provide real-time feedback on infant diets, show current infant diet recommendations, and monitor progress.

Methods: Primary infant caregivers (English or Spanish-literate) with internet access, cellphone text capability, and willing to participate in the full study were enrolled into a parallel-group, randomized controlled trial. Infant diet quality was assessed by the total Diet Quality Index Score (DQIS) at baseline (~ 4 months old) and at the end of the study (~ 9 months old). The DQIS (0-55) is scored as: for 0-5.9 months, 15 points for exclusive and 10 points for partial breastfeeding, and 5 points for formula, while other foods score 5 if not introduced and 0 if introduced; for 6-12 months, appropriate intake of each food group (including formula) scores 5 (2.5 if slightly off, 0 if outside recommendations), with same score for breastfeeding. Total DQIS was categorized as ≥45 (excellent) or below. Data were analyzed with ANCOVA or logistic regression, adjusting for infant age and energy intake.

Results: One hundred fifty-five participants were randomized, and 150 were included in the analysis (76 in the intervention group and 74 in the control group). At the end of the intervention, infant total DQIS was higher in the intervention group (44.6 ± 6.53) than in the control group (42.5 ± 7.5) in both the unadjusted (p = 0.036) and adjusted models (p = 0.046). Also, infants in the control group had twice the odds of having an infant total DQIS below excellent (adjusted OR = 2.00; 95% CI: 1.012-3.950; p = 0.046) compared to the intervention group.

Conclusions: Using the Baby-Feed website for 6 months improved the quality of infant diets. This could be a tool to help caregivers follow current infant diet recommendations with real-time feedback.

Trial registration: Clinicaltrials.gov Identifier: NCT05990439.