Double jeopardy: metabolic syndrome leads to increased sedentary behavior in peri-pubertal minority females.

While most studies have focused on investigating the preventive effects of physical activity on metabolic risk, the longitudinal impacts of metabolic syndrome (MetS) on activity levels is poorly understood. This study aims to examine the influence of MetS on initial activity levels and the trajectory of activity levels in Latina and African American female children over 12 months (n = 55, 9 ± 1 years). Metabolic measures, including fat and lean tissue mass by BodPod, fasting glucose, lipids, blood pressure, and waist circumference, were collected at baseline. Moderate-to-vigorous physical activity and sedentary behavior by accelerometry were collected on a quarterly basis. There were no significant differences in either initial activity levels by MetS status (Moderate-to-vigorous physical activity: 33 ± 12 mins/day for MetS, 48 ± 28 mins/day for Non-MetS, p = .12; sedentary behavior: 408 ± 57 mins/day for MetS, 421 ± 72 mins/day for Non-MetS, p = .67). Longitudinal declines in moderate-to-vigorous physical activity (p = .038) and increases in sedentary behavior (p = .003) were found. Daily sedentary behavior increased by 82.64 more minutes in youth with MetS than in those without over one year (p = .015). This study yields the first evidence of the adverse effect of MetS on sedentary behavior. Targeted intervention strategies to reduce progressive sedentariness evident in minority youth with MetS are warranted.

Recruitment and retention of African American and Latino preadolescent females into a longitudinal biobehavioral study.

OBJECTIVE: Addressing recruitment challenges faced by researchers when the intended participants are young individuals from minority communities is crucial to prevent increases in study costs, prolonged length of the study, and loss of generalizability that may occur due to the resulting higher attrition rates. This article focuses on understanding the differences in census-tract level income, education, and socioeconomic status of young Latina and African American female participants and non-participants during the first 26 months of recruitment (June 2006-August 2008) in a longitudinal biobehavioral study. DESIGN: The Transitions Study examines the psychological and physiological determinants influencing the decrease in physical activity during puberty among Latina and African American girls aged 8 to 11 years within the greater Los Angeles area. Recruitment and retention through five main steps in the process were examined: telephone contact, telephone screening, consent, clinical screening, and baseline overnight visit. RESULTS: As of August 2008, the recruitment pool consisted of 110 African Americans (17.8%) and 373 Latinas (60.4%); of these, only 40 Latinas and 11 African American girls completed the final step into the study. African Americans were less willing to provide their phone numbers, but more likely to be reached at initial phone contact than Latino families. CONCLUSIONS: Understanding the heterogeneity within minority populations, population characteristics, through careful and timely analyses, could be used to adjust recruitment and retention strategies in a study involving minority youth.

Physical inactivity, but not sedentary behavior or energy intake, is associated with higher fat mass in Latina and African American girls.

BACKGROUND: Minority girls are disproportionately affected by overweight and obesity. The independent effects of physical activity (PA), sedentary behavior (SB), and diet are not well understood. OBJECTIVE: This study examined the individual influences of PA, SB and diet on fat mass in Latina and African American (AA) girls, aged 8-11. METHODS: Baseline data from a longitudinal cohort study in minority girls is presented. Multiple linear regression analysis assessed the effects of PA, SB, and energy intake on fat mass, adjusting for lean mass, age, Tanner stage and ethnicity. RESULTS: Participants were 53 Latina and AA girls (77% Latina; M age=9.8 +/- .9; M(BMI%)=80.8 +/- 23.1). Moderate-to-vigorous physical activity (MVPA) by accelerometry (beta= -.13, P<.01) and lean mass (beta=.69, P<.001) were associated with fat mass (Model R2=.63; P<.0001). MVPA by 3-day-physical-activity-recall (beta=-.04, P=.01) and lean mass (beta=.75, P<.001) were associated with fat mass (Model R2=.61; P<.0001). SB and energy intake were not associated with fat mass in any model. CONCLUSION: Using both objective and subjective measures of PA, MVPA, but not SB or diet, was associated with higher fat mass in Latina and AA girls, independent of lean mass, age, Tanner stage, and ethnicity. Prospective studies are needed to clarify the differential impact of diet and activity levels on adiposity in this population.

Psychosocial correlates of eating behavior in children and adolescents: a review.

BACKGROUND: Understanding the correlates of dietary intake is necessary in order to effectively promote healthy dietary behavior among children and adolescents. A literature review was conducted on the correlates of the following categories of dietary intake in children and adolescents: Fruit, Juice and Vegetable Consumption, Fat in Diet, Total Energy Intake, Sugar Snacking, Sweetened Beverage Consumption, Dietary Fiber, Other Healthy Dietary Consumption, and Other Less Healthy Dietary Consumption in children and adolescents. METHODS: Cross-sectional and prospective studies were identified from PubMed, PsycINFO and PsycArticles by using a combination of search terms. Quantitative research examining determinants of dietary intake among children and adolescents aged 3-18 years were included. The selection and review process yielded information on country, study design, population, instrument used for measuring intake, and quality of research study. RESULTS: Seventy-seven articles were included. Many potential correlates have been studied among children and adolescents. However, for many hypothesized correlates substantial evidence is lacking due to a dearth of research. The correlates best supported by the literature are: perceived modeling, dietary intentions, norms, liking and preferences. Perceived modeling and dietary intentions have the most consistent and positive associations with eating behavior. Norms, liking, and preferences were also consistently and positively related to eating behavior in children and adolescents. Availability, knowledge, outcome expectations, self-efficacy and social support did not show consistent relationships across dietary outcomes. CONCLUSION: This review examined the correlates of various dietary intake; Fruit, Juice and Vegetable Consumption, Fat in Diet, Total Energy Intake, Sugar Snacking, Sweetened Beverage Consumption, Dietary Fiber, Other Healthy Dietary Consumption, and Other Less Healthy Dietary Consumption in cross-sectional and prospective studies for children and adolescents. The correlates most consistently supported by evidence were perceived modeling, dietary intentions, norms, liking and preferences. More prospective studies on the psychosocial determinants of eating behavior using broader theoretical perspectives should be examined in future research.

Incorporating prototyping and iteration into intervention development: a case study of a dining hall-based intervention.

BACKGROUND: Previous research from the fields of computer science and engineering highlight the importance of an iterative design process (IDP) to create more creative and effective solutions. OBJECTIVE: This study describes IDP as a new method for developing health behavior interventions and evaluates the effectiveness of a dining hall-based intervention developed using IDP on college students' eating behavior and values. PARTICIPANTS: participants were 458 students (52.6% female, age = 19.6 ± 1.5 years [M ± SD]). METHODS: The intervention was developed via an IDP parallel process. A cluster-randomized controlled study compared differences in eating behavior among students in 4 university dining halls (2 intervention, 2 control). RESULTS: The final intervention was a multicomponent, point-of-selection marketing campaign. Students in the intervention dining halls consumed significantly less junk food and high-fat meat and increased their perceived importance of eating a healthful diet relative to the control group. CONCLUSION: IDP may be valuable for the development of behavior change interventions.

Temporal relationship between insulin sensitivity and the pubertal decline in physical activity in peripubertal Hispanic and African American females.

OBJECTIVE: Little attention has been paid to possible intrinsic biological mechanisms for the decline in physical activity that occurs during puberty. This longitudinal observational study examined the association between baseline insulin sensitivity (SI) and declines in physical activity and increases in sedentary behavior in peripubertal minority females over a year. RESEARCH DESIGN AND METHODS: Participants were Hispanic and African American girls (n = 55; 76% Hispanic; mean age 9.4 years; 36% obese). SI and other insulin indices were measured at baseline using the frequently sampled intravenous glucose tolerance test. Physical activity was measured on a quarterly basis by accelerometry and self-report. RESULTS: Physical activity declined by 25% and time spent in sedentary behaviors increased by ∼13% over 1 year. Lower baseline SI predicted the decline in physical activity measured by accelerometry, whereas higher baseline acute insulin response to glucose predicted the decline in physical activity measured by self-report. Time spent in sedentary behavior increased by ~13% over 1 year, and this was predicted by lower baseline SI. All models controlled for adiposity, age, pubertal stage, and ethnicity. CONCLUSIONS: When evaluated using a longitudinal design with strong outcome measures, this study suggests that lower baseline SI predicts a greater decline in physical activity in peripubertal minority females.

CRP is related to higher leptin levels in minority peripubertal females regardless of adiposity levels.

Overweight is related to higher levels of C-reactive protein (CRP) and leptin, which have been independently associated with increased risk for diabetes, cardiovascular disease, and the metabolic syndrome. Elevated CRP may trigger leptin resistance by inhibiting the binding of leptin to its receptors. We cross-sectionally examined the relationship between CRP, leptin, BMI z-score, percent body fat (%BF) assessed by air plethysmography (BodPod), and insulin sensitivity (SI) and acute insulin response (AIRg) measured by intravenous glucose tolerance test in 51 Latina and African-American females (77% Latina), mean age 9.2 (±0.9) years, at either Tanner Pubertal Stage (TPS) 1 (n = 25) or TPS 2 (n = 26). Females at TPS 2 had higher BMI z-scores, %BF (23% ± 10.1 vs. 30% ± 10.0, P = 0.02), AIRg (976.7 ± 735.2 vs. 1555.3 ± 1,223 µIU/ml, P = 0.05), fasting insulin (11.0 ± 10.8 vs. 17.2 ± 13.6 µlU/ml, P = 0.00) and leptin levels (11.0 ± 7.1 vs. 19.6 ± 10.9 ng/ml, P < 0.001) than those at TPS 1. There were no ethnic differences in any of the measured variables. CRP was positively correlated with BMI z-score (P = 0.001), %BF (P = 0.006), fasting insulin and AIRg (P = 0.02), and fasting leptin (P = 0.00), and negatively correlated with SI (P = 0.05). A linear regression model showed that CRP independently explained 10% (P = 0.00) of the variance in leptin after adjusting %BF, TPS, ethnicity, habitual physical activity and SI. Hence, low-grade inflammation may contribute to prolonged leptin exposure and leptin resistance, even in healthy children.

Psychometrics of the Eating in Emotional Situations Questionnaire (EESQ) among low-income Latino elementary-school children.

The current study examines the psychometric properties of the Eating in Emotional Situations Questionnaire (EESQ) and the frequency of eating in emotional situations among 159 low-income Latino fourth graders. The EESQ assesses eating in emotional situations that are emotion-driven ("I eat when I am lonely") and context-driven ("I eat when I get a really bad grade"). Internal consistencies for the EESQ subscales and total scale ranged from .70 to .86. Criterion validity of the EESQ was established by statistically significant correlations between the EESQ subscales and total scale, and uncontrollable eating, external eating, and junk food intake. Eating in emotional situations was common in the sample; almost one-half reported eating in at least 3 of the 11 types of emotional situations (e.g. when stressed, sad, or bored) and 28% reported eating in at least 6 types. Overall, these findings provide support for the internal consistency and validity of the EESQ in low-income Latino children, and suggest that eating in emotional situations is moderately present in this demographic. Future studies are needed to validate the EESQ in other ethnic groups and examine the longitudinal tracking of eating in emotional situations among Latino youth.

Influences of social support, perceived barriers, and negative meanings of physical activity on physical activity in middle school students.

BACKGROUND: A profound decline in physical activity occurs in puberty. This phenomenon is not well understood. Therefore, the purpose of this study is to examine associations between family/friend social support for physical activity, negative meanings of physical activity (NMPA), and internal /external barriers to physical activity with moderate to vigorous physical activity (MVPA), and sedentary and light behavior (SLB) in youth. METHODS: A total of 350 participants from 7 Los Angeles County middle schools participated in the study (62% Latina, 79% females). Hypothesized pathways were examined using structural equation modeling. Psychosocial variables and participation in MVPA and SLB were assessed by self-reported questionnaires. RESULTS: NMPA were related to lower levels of family/friend social support and greater internal/external barriers. Family social support was the only significant indicator of MVPA (ß=0.79). Low family social support was related to higher SLB (ß=-0.25). CONCLUSIONS: Family social support seems crucial to promote MVPA and reduce SLB in adolescents and might be influenced by child's feelings about physical activity. Future research should consider the interrelationship between psychosocial correlates of physical activity.

Measuring the meanings of eating in minority youth.

The aim of this study is to present the development of the Meanings of Eating Index (MEI) in a diverse sample of children. Exploratory factor analysis was performed on MEI items. Factors with eigenvalues above 1.0 were retained. Items that loaded on multiple factors or with item-total correlations below 0.50 were discarded. A 24-item, 5-factor scale comprised the final MEI. Personal Negative Emotions and Disturbed Eating were positively associated with frequency of high calorie snack food intake (r=0.21, p<0.05; r=0.33, p<0.01), and Personal Well Being was positively associated with eating vegetables more frequently (r=0.20; p<0.05). Eating on Behalf of Others was negatively associated with frequency of vegetable intake (r=-.20; p<0.05). Pleasure Eating was not associated with dietary intake. The MEI shows promise as a tool for understanding the affective determinants of dietary intake in minority youth.

The influence of worries on emotional eating, weight concerns, and body mass index in Latina female youth.

PURPOSE: To investigate the effect of worries on weight concerns, emotional eating, and body mass index (BMI) percentile in an ethnically diverse sample of female youth. METHODS: This study used baseline and follow-up data from a brief school-based physical activity intervention trial involving minority female youth. Partial correlations adjusted for intervention status, age, and ethnicity were used to assess the relationships between emotional eating, weight concerns, and BMI percentile at follow-up. Multilevel modeling was used to analyze the relationships between baseline worries and follow-up emotional eating, weight concerns, and BMI percentile. Additional analysis assessed whether emotional eating mediated and/or moderated the relationship between baseline worries and follow-up BMI. Data were analyzed using SAS version 9.1. RESULTS: The sample consisted of 404 minority females (67.1% Latina; mean age = 12.5 ± .6; 60.6% were of normal weight). Weight concerns were positively correlated with emotional eating and BMI percentile (p < .001 for both). At follow-up, baseline worries significantly predicted emotional eating (p = .027) and weight concerns (p < .001) but not BMI percentile (p = .183). Emotional eating did not mediate the relationship between baseline worries and follow-up BMI percentile; however, it did moderate the relationship between baseline worries and follow-up BMI percentile (p = .003). CONCLUSIONS: In this sample, worries were associated with psychosocial variables but not with BMI percentile. Reducing worries in those with high emotional eating scores may influence future weight gain among Latina females.

Physical activity, sedentary behavior, and the metabolic syndrome in minority youth.

PURPOSE: This study aimed to determine the associations among physical activity, sedentary behavior, and the metabolic syndrome (MetS) in Latino and African American youth using both subjective and objective measures of activity levels. METHODS: Cross-sectional data from 105 participants from three pediatric obesity studies that share a core set of methods and measures (Latino 74%, female 75%, mean age = 13 ± 3 yr) were used. Measures included moderate-to-vigorous physical activity and sedentary behavior by accelerometry and 3-Day Physical Activity Recall (3DPAR), fat and lean tissue mass by BodPod™, fasting glucose, lipids, blood pressure, and waist circumference. Associations between physical activity, sedentary behavior, and MetS were examined using ANCOVA, Pearson correlations, partial correlations, and logistic regressions with adjustments for age, sex, ethnicity, fat and lean mass, and pubertal Tanner stage. RESULTS: Accelerometry data showed that greater time engaging in moderate-to-vigorous physical activity was related to lower odds of the MetS (odds ratio = 0.49, 95% confidence interval = 0.25-0.98), independent of sedentary behavior and covariates, and inversely correlated with fasting glucose (r = -0.21, P = 0.03) and systolic blood pressure (r = -0.25, P = 0.01), adjusting for covariates. Data from the 3DPAR showed that higher levels of sedentary behavior were related to higher odds of the MetS (odds ratio = 4.44, 95% confidence interval = 1.33-14.79), independent of moderate-to-vigorous physical activity and covariates, negatively correlated with HDL-cholesterol (r = -0.21, P = 0.04) and positively correlated systolic blood pressure (r = 0.26, P = 0.009), adjusting for covariates. CONCLUSIONS: Future interventions aiming to improve metabolic health in youth should target both the promotion of physical activity and the reduction of sedentary behavior. Subjective and objective measures should be used in conjunction to better capture activity behaviors.

Anxiety mediates the relationship between sleep onset latency and emotional eating in minority children.

This study examined associations between sleep onset latency and emotional eating in a minority sample of children. A cross-sectional school-based study of sleep, psychological constructs, diet and physical activity was conducted in 6 public and private schools in Los Angeles County. An ethnically diverse sample of 356 third through fifth graders completed confidential self-report surveys. Multilevel regression (MLM) analyses were conducted to study associations while controlling for gender, ethnicity, and the random effect of school. Girls made up 57% of the total sample, which was predominantly Latino (42.6%), followed by African Americans (21.6%) and Asians (19.2%). MLM revealed that there were significant associations between sleep onset latency and emotional eating (p=.030), depressive symptomology (p<.0001) and trait anxiety (p<.0001). Sobel's test for mediation showed that trait anxiety (p=.011) but not depressive symptomology (p=.141) was a mediator of the relationship between sleep onset latency and emotional eating. Thereby providing a mechanism through which sleep onset latency is related to emotional eating. These findings suggest that sleep onset latency is associated with increased anxiety, depressive symptoms, and emotional eating. Although causal inferences cannot be drawn from this cross-sectional data, future studies should examine the possibility that problems falling asleep could lead to emotional dysregulation that in turn leads to emotional eating. Emotional eating may be one avenue by which sleep disturbances lead to overweight and obesity.