Diet and Physical Activity by Prediabetes Status Among U.S. Adolescents: National Health and Nutrition Examination Survey, 2007-2018.

Background: Prediabetes among adolescents is on the rise, yet it is unclear if modifiable risk factors vary by prediabetes status. Methods: This study examined associations between diet (primary objective) and physical activity (secondary objective) by prediabetes status among U.S. adolescents (12-19 years) who participated in the National Health and Nutrition Examination Survey from 2007-2018. Differences in Healthy Eating Index (HEI)-2015-2020 scores (total and 13 component scores), nutrients of public health concern, and physical activity were examined by prediabetes status (no prediabetes vs. prediabetes). Results: Adolescents (n = 2,487) with prediabetes had significantly lower whole grains component scores and intakes of vitamin D, phosphorus, and potassium (all p < .05), than adolescents without prediabetes. Physical activity levels were not optimal for either group, there were no differences by prediabetes status (n = 2,188). Conclusion: Diabetes prevention interventions for adolescents are needed and should promote a healthy diet target and encourage physical activity.

Weight-related Self-monitoring App Use Among Emerging Adults is Cross-sectionally Associated With Amount and Type of Physical Activity and Screen Time.

Weight-related self-monitoring (WRSM) apps are often used by emerging adults to assist in behavior change. However, little is known about the relationship between WRSM among the general population of emerging adults and various physical activity and screen time behaviors. This paper examines associations between WRSM app use and various forms of physical activity and screen time among a population-based sample of emerging adults. Data come from EAT 2018 (N = 1,568, mean age = 22.0 ± 2.0 years), a population-based sample of emerging adults from Minneapolis/St. Paul, Minnesota. Participants reported on the types of WRSM apps used (physical activity and/or dietary focused), in addition to how much time they spent doing physical activity, whether they practiced yoga, compulsive exercise, recreational screen time, social media use, and whether they viewed dieting/weight loss materials. Linear and logistic regressions were used to assess adjusted means and prevalences of outcomes. We found that physical activity-focused WRSM app users engaged in more hours of total (8.7 vs 7.2, P < .001), and moderate-to-vigorous (5.1 vs 4.3, P = .002) physical activity compared to non-users. Similar results were found for dietary WRSM app users compared to non-users. However, WRSM app users had higher levels of compulsive exercise and were more likely to view dieting/weight loss materials (Ps < .001). Findings suggest that although physical activity is higher among WRSM users, the types of physical activity and screen time behaviors WRSM users are engaging in may be harmful.

Does Weight-Motivation for Exercise Predict Physical Activity Levels Across the Life Course From Adolescence to Adulthood?

Healthcare professionals may motivate their patients to exercise to lose weight, but it is unknown how weight-focused motivations influence young peoples' PA trajectories. PURPOSE: To examine if weight-motivated exercise predicts moderate-to-vigorous physical activity (MVPA) from adolescence to adulthood in a population-based sample and if this relationship differs by age and body mass index (BMI). METHODS: Participants (N = 1,428; 13-18 years at baseline; 48.6% female; 49.0% white) responded to surveys in the 15-year longitudinal study, Project EAT (Eating and Activity in Teens and Young Adults). Weight-motivated exercise was examined as a predictor of MVPA across the life course at five-year intervals using linear regression generalized estimating equations and adjusting for demographics (age modeled continuously), BMI (modeled continuously), weight-related intentions, and prior MVPA. RESULTS: Weight-motivated exercise predicted higher subsequent MVPA at five-year intervals among females (B = .57, 95% CI:0.13, 1.00) but not males (B = .31, 95% CI:-.09, .72). The association differed by BMI in females (p = .02); weight-motivated exercise was associated with higher subsequent MVPA at lower BMI but lower subsequent MVPA at higher BMI. The association also differed by age in males (p = .008), such that older males who reported weight-motivated exercise had higher subsequent MVPA, whereas this association was not present in younger males. CONCLUSION: Weight-motivated exercise may have a deleterious influence on MVPA for females with higher BMI and may have an advantageous influence on older males. Understanding how motivations for exercise may influence PA trajectories can inform PA promotion over the life course by providing more nuanced guidance by age, BMI, and sex.

Stay-at-Home Orders during COVID-19: The Influence on Physical Activity and Recreational Screen Time Change among Diverse Emerging Adults and Future Implications for Health Promotion and the Prevention of Widening Health Disparities.

BACKGROUND: The purpose of this study was to examine changes in physical activity (PA) and recreational screen time (RST) behaviors from pre-COVID-19 in 2018 to Spring 2020 during the mandatory stay-at-home order in an ethnically/racially, socioeconomically diverse sample of emerging adults. METHODS: Longitudinal data were analyzed from 218 participants (Mage = 24.6 ± 2.0 years) who completed two surveys: EAT 2018 (Eating and Activity over Time) and C-EAT in 2020 (during COVID-19). Repeated ANCOVAs and multiple linear regression models were conducted. RESULTS: Moderate-to-vigorous and total PA decreased (4.7 ± 0.3 to 3.5 ± 0.3 h/week [p < 0.001] and 7.9 ± 0.4 to 5.8 ± 0.4 h/week [p < 0.001], respectively), and RST increased from 26.5 ± 0.9 to 29.4 ± 0.8 h/week (p = 0.003). Perceived lack of neighborhood safety, ethnic/racial minoritized identities, and low socioeconomic status were significant predictors of lower PA and higher RST during COVID-19. For example, low SES was associated with 4.04 fewer hours of total PA compared to high SES (p < 0.001). CONCLUSIONS: Stay-at-home policies may have significantly influenced PA and RST levels in emerging adults with pre-existing disparities exacerbated during this mandatory period of sheltering-in-place. This suggests that the pandemic may have played a role in introducing or magnifying these disparities. Post-pandemic interventions will be needed to reverse trends in PA and RST, with a focus on improving neighborhood safety and meeting the needs of low socioeconomic and ethnic/racial minoritized groups.

Changes to Physical Activity during a Global Pandemic: A Mixed Methods Analysis among a Diverse Population-Based Sample of Emerging Adults in the U.S.

Emerging adults' lives have changed because of the COVID-19 pandemic. Physical activity (PA) behaviors need to be examined to inform interventions and improve health. Responses to the C-EAT (COVID-19 Eating and Activity over Time) survey (N = 720; age = 24.7 ± 2.0 yrs) were analyzed. This mixed-methods study quantitatively examined changes in self-reported PA (hours/week of mild PA, moderate-to-vigorous PA (MVPA), and total PA) from 2018 to 2020. Qualitative responses on how COVID-19 impacted PA were analyzed using a grounded theory approach. Hours of PA were lower on average for all intensity levels during COVID-19 than in 2018 (p's < 0.0001). Over half of the sample reported a decrease in MVPA (53.8%) and total PA (55.6%); 42.6% reported a decrease in mild PA. High SES were more likely to report an increase in total PA (p = 0.001) compared to those of lower SES. Most (83.6%) participants perceived that COVID-19 had influenced their PA. The most common explanations were decreased gym access, effects on outdoor PA, and increased dependence on at-home PA. Results suggest that emerging adults would benefit from behavioral interventions and health promotion efforts in response to the pandemic, with a focus on activities that can be easily performed in the home or in safe neighborhood spaces.

Use of Wearable Technology and Social Media to Improve Physical Activity and Dietary Behaviors among College Students: A 12-Week Randomized Pilot Study.

College students demonstrate poor physical activity (PA) and dietary behaviors. We evaluated the feasibility of a combined smartwatch and theoretically based, social media-delivered health education intervention versus a comparison on improving college students' health behaviors/outcomes. Thirty-eight students (28 female; Xage = 21.5 ± 3.4 years) participated in this two-arm, randomized 12-week pilot trial (2017-2018). Participants were randomized into: (a) experimental: Polar M400 use and twice-weekly social cognitive theory- and self-determination theory-based Facebook-delivered health education intervention; or (b) comparison: enrollment only in separate, but content-identical, Facebook intervention. Primary outcomes pertained to intervention feasibility. Secondary outcomes included accelerometer-estimated PA, physiological/psychosocial outcomes, and dietary behaviors. Intervention adherence was high (~86%), with a retention of 92.1%. Participants implemented health education tips 1-3 times per week. We observed experimental and comparison groups to have 4.2- and 1.6-min/day increases in moderate-to-vigorous PA (MVPA), respectively, at six weeks-partially maintained at 12 weeks. In both groups, similarly decreased body weight (experimental = -0.6 kg; comparison = -0.5 kg) and increased self-efficacy, social support, and intrinsic motivation were observed pre- and post-intervention. Finally, we observed small decreases in daily caloric consumption over time (experimental = -41.0 calories; comparison = -143.3). Both interventions were feasible/of interest to college students and demonstrated initial effectiveness at improving health behaviors/outcomes. However, smartwatch provision may not result in an additional benefit.

Physical Activity and Sociodemographic Correlates of Adolescent Exergamers.

PURPOSE: Exergame use (or active video games that promote physical activity [PA]) has the potential to increase PA in youth, but there is a scarcity of information about PA of youth who are current exergamers. The current study examined PA behaviors in exergamers versus nonexergamers. METHODS: Adolescents (N = 2,793; mean age = 14.4 ± 2.0 years) participating in EAT 2010 (Eating and Activity in Teens) self-reported sociodemographic characteristics and exergaming and PA behavior. Height and weight were measured. RESULTS: Both male and female exergamers tended to be younger and black compared with nonexergamers (p < .001). Generally, exergamers did not report significantly more PA than nonexergamers, except for female exergamers who engaged in more vigorous PA than female nonexergamers (p < .01; 1.3 ± .05 h/wk vs. 1.6 ± .06 h/wk, respectively). CONCLUSIONS: PA behavior in exergamers is similar to PA behavior in nonexergamers. However, when targeting vigorous PA, exergaming may be an innovative and appealing intervention strategy for adolescent girls.

Comparison of traditional versus mobile app self-monitoring of physical activity and dietary intake among overweight adults participating in an mHealth weight loss program.

OBJECTIVE: Self-monitoring of physical activity (PA) and diet are key components of behavioral weight loss programs. The purpose of this study was to assess the relationship between diet (mobile app, website, or paper journal) and PA (mobile app vs no mobile app) self-monitoring and dietary and PA behaviors. MATERIALS AND METHODS: This study is a post hoc analysis of a 6-month randomized weight loss trial among 96 overweight men and women (body mass index (BMI) 25-45 kg/m(2)) conducted from 2010 to 2011. Participants in both randomized groups were collapsed and categorized by their chosen self-monitoring method for diet and PA. All participants received a behavioral weight loss intervention delivered via podcast and were encouraged to self-monitor dietary intake and PA. RESULTS: Adjusting for randomized group and demographics, PA app users self-monitored exercise more frequently over the 6-month study (2.6±0.5 days/week) and reported greater intentional PA (196.4±45.9 kcal/day) than non-app users (1.2±0.5 days/week PA self-monitoring, p<0.01; 100.9±45.1 kcal/day intentional PA, p=0.02). PA app users also had a significantly lower BMI at 6 months (31.5±0.5 kg/m(2)) than non-users (32.5±0.5 kg/m(2); p=0.02). Frequency of self-monitoring did not differ by diet self-monitoring method (p=0.63); however, app users consumed less energy (1437±188 kcal/day) than paper journal users (2049±175 kcal/day; p=0.01) at 6 months. BMI did not differ among the three diet monitoring methods (p=0.20). CONCLUSIONS: These findings point to potential benefits of mobile monitoring methods during behavioral weight loss trials. Future studies should examine ways to predict which self-monitoring method works best for an individual to increase adherence.

Does participation in organized sports predict future physical activity for adolescents from diverse economic backgrounds?

PURPOSE: To examine cross-sectional and longitudinal associations between socioeconomic status (SES), gender, sports participation and moderate-to-vigorous physical activity (MVPA) in adolescents. METHODS: Project EAT (Eating Among Teens), a population-based longitudinal study followed a socioeconomically and ethnically diverse sample of 1709 adolescents in 1998-1999 (Time 1) and 2003-2004 (Time 2). Mixed model regression analyses were used to examine longitudinal trends in MVPA as a function of SES and previous sports involvement. RESULTS: For both genders, participation in organized sports and weekly hours of MVPA were positively associated with SES. On average, MVPA decreased between high school and young adulthood for both genders. Adolescents who participated in sports during high school showed a steeper decline in weekly hours of MVPA than their non-sports-participating counterparts. SES had a significant moderating effect on the change in MVPA over time for boys who participated in organized sports, with low SES boys showing a steeper decline in MVPA between time periods than higher SES boys. Although on average, a statistically significant difference in MVPA between previous sports participants and nonparticipants remained at Time 2, for all SES groups and both genders, the gap between hours of MVPA was either overcome or significantly narrowed by young adulthood. CONCLUSIONS: Increased dependence on organized sports for MVPA may be insufficient to meet the needs of youth following high school, especially for low SES youth. Designing physical activity promotions that reach and address the unique needs of lower SES youth and families is a public health priority.

Characteristics associated with older adolescents who have a television in their bedrooms.

OBJECTIVES: The goals were to examine the prevalence of adolescents having a television in their bedroom and to describe associated personal, social, and behavioral characteristics. METHODS: Participants included 781 adolescents (mean age: 17.2 years) who completed a mailed Project Eating Among Teens II questionnaire. The relationships between adolescents having a television in their bedroom and sociodemographic, behavioral, and personal characteristics were examined. RESULTS: Nearly two thirds (62%) of participants had a bedroom television. Gender, race/ethnicity, socioeconomic status, and age were associated with the presence of a bedroom television. Compared with girls without a bedroom television, girls with a bedroom television reported less time spent in vigorous activity (1.8 vs 2.5 hours/week), more time spent watching television (20.7 vs 15.2 hours/week), lower vegetable intake (1.7 vs 2.0 servings per day), greater sweetened beverage consumption (1.2 vs 1.0 servings per day), and fewer family meals (2.9 vs 3.7 meals per week). Compared with boys without a bedroom television, boys with a bedroom television reported more time spent watching television (22.2 vs 18.2 hours/week), lower fruit intake (1.7 vs 2.2 servings per day), fewer family meals (2.9 vs 3.6 meals per week), and lower grade point average (2.6 vs 2.9). Twice as many youths with a television in their bedroom were heavy television users (watched >5 hours/day), compared with youths without a television in their bedroom (16% vs 8%). CONCLUSIONS: Adolescents with a bedroom television reported more television viewing time, less physical activity, poorer dietary habits, fewer family meals, and poorer school performance. Refraining from placing a television in teenagers' rooms may be a first step in helping to decrease screen time and subsequent poor behaviors associated with increased television watching.

Health status of non-Hispanic U.S.-born and foreign-born black and white persons: United States, 1992-95.

OBJECTIVE: This report describes differences in selected sociodemographic and health characteristics of the non-Hispanic U.S. population by race (black and white) and nativity (U.S-born and foreign-born), using data from the 1992-95 National Health Interview Surveys (NHIS). METHODS: Data were collected for a household, multistage probability sample representative of the U.S. civilian noninstitutionalized population. A total of 456,729 persons were included in these analyses for the 4 data years combined. Statistics were age adjusted to the 2000 U.S. standard population, and unadjusted estimates are also presented for comparison. RESULTS: Over 87 percent of the foreign-born black population assessed their health as being excellent or very good, significantly higher than U.S.-born black persons (52 percent), and similar to U.S.- and foreign-born white persons (69 percent for each group). Eleven percent of foreign-born black persons were limited in performing some type of activity, compared with 20 percent of their U.S.-born counterparts. Among white persons, 14 percent of foreign-born and 16 percent of U.S.-born individuals were limited in activity. The foreign-born black population, especially women, had the lowest current smoking prevalence of all of the study groups. CONCLUSIONS: The data show significant differences in health characteristics between groups classified by race and nativity. Information about the nativity status of black and white populations may be useful in public health efforts to eliminate health disparities.