Effects of light-intensity physical activity on cardiometabolic parameters in young adults with overweight and obesity: The SED-ACT randomized controlled crossover trial.

AIMS: To investigate how a change in body position with light-intensity physical activity (PA) 'snacks' (LIPAS, alternate sitting and standing, walking or standing continuously) compared with uninterrupted prolonged sitting affects glucose metabolism and heart rate variability (HRV) parameters in young adults with overweight and obesity. MATERIALS AND METHODS: We conducted a four-arm randomized controlled crossover trial. The following conditions were tested during an 8-h simulated workday: uninterrupted prolonged sitting (SIT), alternate sitting and standing (SIT-STAND; 2.5 h total), continuous standing (STAND), and continuous walking (1.0 mph; WALK). The primary outcome was to investigate how a change in body position (alternate sitting and standing, walking or standing continuously) compared with uninterrupted sitting affects mean 8-h glucose metabolism. Secondary outcomes included the effects on 2-h postprandial glucose concentrations, as well as on 8-h/24-h heart rate and HRV parameters, in the respective study arms. Capillary blood samples were drawn from an hyperemised earlobe in the fasted state and once every hour during each trial intervention by puncturing the earlobe with a lancet and collecting 20 µL of blood (Biosen S-Line Lab+; EKF diagnostics, Barleben, Germany). HRV was assessed for 24 h including the 8-h intervention phase, and a home phase by means of a Holter electrocardiogram. All participants received the same standardized non-relativised breakfast and lunch during the four trial visits. RESULTS: Seventeen individuals (eight women, mean age 23.4 ± 3.3 years, body mass index 29.7 ± 3.8 kg/m2, glycated haemoglobin level 34.8 ± 3.1 mmol/mol [5.4 ± 0.3%], body fat 31.8 ± 8.2%) completed all four trial arms. Compared with SIT (89.4 ± 6.8 mg/dL), 8-h mean glucose was lower in all other conditions (p < 0.05) and this was statistically significant compared with WALK (86.3 ± 5.2 mg/dL; p = 0.034). Two-hour postprandial glucose after breakfast was approximately 7% lower for WALK compared with SIT (p = 0.002). Furthermore, significant time × condition effects on HRV parameters favouring light-intensity walking were observed (p < 0.001). CONCLUSIONS: Replacement and interruption of prolonged sitting with light-intensity walking showed a significant blood glucose-lowering effect and improved HRV during an 8-h work environment in young adults with overweight and obesity.

Beyond BMI: waist circumference and social environment is associated with motor performance ability in kindergartners.

BACKGROUND: The aim of the current study was to examine the relationship between anthropometric characteristics (i.e. body height, body weight, body mass index [BMI] and waist circumference [WC]) with motor performance ability [MPA], social environmental factors of the district (i.e. employment status/working life, education, social situation/heterogeneity and home environment), where the respective kindergarten was located, as well as other potential health determinants in a representative sample of kindergartners. METHODS: We analyzed data of 434 children aged 3 to 6 years which were obtained from a community-based cross-sectional health study conducted in the city of Mainz, Germany. Body height and weight, BMI and WC standard deviation scores [SDS] were calculated relative to the international proposed cut-offs of the IOTF. MPA was collected with multiple test items to determine coordination, speed strength, muscular endurance and speed. The life situation index [LSI] was used to assess the social environment of the district of the kindergarten. Adjusted for covariates, correlation and logistic regression analyses were conducted to estimate the effect of WC on MPA. RESULTS: Below-average MPA was found in 46% of the sample. While there was no relationship to BMI (odds ratio [OR]: 1.09, 95% confidence interval [95% CI]: 0.83-1.44; p = 0.538), WC SDS was positively associated with below-average MPA (OR: 1.41, 95% CI: 1.01-1.95; p = 0.041). Further results show that the social environment of the district of the kindergarten was independently related to below-average MPA (OR: 2.72, 95% CI: 1.29-5.75; p = 0.009). CONCLUSION: The findings suggest that WC rather than BMI is linked to measurements of MPA already in kindergartners and furthermore, there seems to be an independent association between MPA and the social environment of the district of the respective kindergarten.

Child-caregivers' body weight and habitual physical activity status is associated with overweight in kindergartners.

BACKGROUND: The aim of this study was to examine whether child-caregivers', both parents and kindergarten teachers, health parameters (age, weight status, habitual physical activity score) are significantly associated with the risk of overweight in young children. METHODS: We assessed the individual body mass index standard deviation score in a regional cross-sectional health study and matched a representative sample of 434 kindergartners aged 3 to 6-years with their caregivers' weight and habitual physical activity status. Furthermore, we identified factors associated with the general ability of child-caregivers to identify overweight in children, and the awareness to classify a child within the correct weight category. RESULTS: Our study confirmed most of the known associations between parental anthropometrics and psychosocial factors with childhood overweight and obesity. A significantly higher proportion of boys tended to be overweight or obese (p = 0.027) and parents were more likely to misclassified boys overweight as normal weight (OR: 1.86; 95% CI 1.21-2.86). Adjusted for confounders, logistic regression analysis revealed that kindergarten teachers' weight status (OR: 1.97; 95%-CI: 1.01-3.83) and habitual physical activity scores (OR: 2.32; 95%-CI: 1.10-4.92) were associated with children's weight status. CONCLUSIONS: Kindergarten teachers' weight and habitual physical activity score seem to be new independent risk factors for overweight in kindergartners 3 to 6-years of age. Our results suggest that the psychosocial, non-genetic association of non-parental child-caregivers on children's weight is relatively high and that the association of non-parental child-caregivers warrants further investigation.

Obesity prevalence and unfavorable health risk behaviors among German kindergarten teachers: cross-sectional results of the kindergarten teacher health study.

BACKGROUND: The aim of the study was to investigate obesity status and associated health risk behaviors in a sample of German kindergarten teachers. At present, such data are not available, despite the fact that kindergarten teachers educate children at a formative time in their lives. METHODS: Kindergarten teachers aged 18-62 years (n = 313) were invited to participate in the Kindergarten Teacher Health Study (KTHS) by completing a self-reported questionnaire. We analyzed their obesity status, health risk behaviors (i.e., habitual physical activity, screen time activities, eating behavior patterns, smoking), and their general ability to identify overweight children and the associated health risks of overweight and obesity based on special age- and sex-specific silhouettes. After adjusting for covariates, bivariate correlations were conducted for associations between body mass index (BMI) and health risk behaviors, while analyses of variance (ANOVAs) were used to analyze differences of health risk behaviors between BMI groups. Logistic regression analyses were conducted to predict determinants of kindergarten teachers who did not correctly identify the overweight silhouettes and their associated physical and mental health risks. Additionally, data regarding kindergarten teachers' weight status and smoking behavior were compared with nationally representative data from the 2009 Microcensus (n = 371310) using the Mann-Whitney U-test. RESULTS: The prevalence rates of overweight and obesity were 41.2% and 17.9%, respectively. The prevalence of obesity was significantly higher in kindergarten teachers (p < 0.001) compared to national Microcensus data. Only 44.6% of teachers were able to identify overweight children correctly. The fact that being overweight is associated with physical and mental health risks was only reported by 40.1% and 21.2% of teachers, respectively. Older kindergarten teachers were more likely to misclassify the overweight silhouettes, while younger, normal-weight, and overweight kindergarten teachers were more likely to underestimate the associated health risks. Obese kindergarten teachers reported spending more time in front of computer and television screens than their normal-weight counterparts, especially on weekends. In addition, obese kindergarten teachers reported eating less often with their families and more frequently reported watching television during meals. CONCLUSIONS: Advanced monitoring and multifaceted interventions to improve the health behaviors of kindergarten teachers should be given high priority. Because kindergarten teachers' behavioral modeling presumably mediates children's health behaviors, additional research is needed about kindergarten teachers' health and its proposed interaction with children's health.

Association of meeting both muscle strengthening and aerobic exercise guidelines with prevalent overweight and obesity classes - results from a nationally representative sample of German adults.

OBJECTIVES: German national physical activity guidelines specify adults (≥18 years) should engage in at least: (i) 150 min of aerobic moderate-to-vigorous-intensity physical activity/week (MVPA); and (ii) muscle-strengthening exercise (MSE) 2 days/week. However, the relationship between MVPA and MSE and overweight/obesity has not been examined among German adults. Aim of this study was to examine whether meeting the guidelines for both MVPA and MSE is associated with a lower prevalence of overweight/obesity compared to meeting MVPA or MSE alone or none of them, among a nationally representative sample of German adults. METHODS: The cross-sectional study drew data from the 2014 German Health Update (GEDA) (n=22,822; ≥18 years). Physical activity (MVPA-MSE), height/weight, socio-demographic, health and lifestyle factors were assessed by self-report via validated questionnaires. Generalized linear models with Poisson regression were used to assess prevalence ratios of Body Mass Index-derived (BMI) overweight/obesity across categories of physical activity guideline adherence (met neither; MSE only; MVPA only; met both). RESULTS: Compared to other physical activity groups, meeting both the MVPA-MSE guidelines was associated with the lowest prevalence rate of overweight/obesity (Adjusted Prevalence Ratios [APR] range: 0.25-0.73). Associations between BMI and physical activity were strongest among Class II obesity (APR range: 0.25-0.45). The associations remained consistent after adjusting sociodemographic and lifestyle factors. CONCLUSIONS: Meeting the combined MVPA-MSE guideline, as suggested in the German national physical activity recommendations, showed the lowest overweight/obesity prevalence. Promoting uptake and adherence of both MVPA and MSE at the population level could help to reduce the public health burden of obesity.Highlights Meeting both muscle strengthening and aerobic exercise guidelines show the lowest overweight/obesity prevalence in a German representative sample of adults. Promoting uptake and adherence of both MVPA and MSE at the population level could help to reduce the public health burden of obesity.

Convenience Behavior and Being Overweight in Adults: Development and Validation of the Convenience Behavior Questionnaire.

The etiology of overweight and obesity is a mixture of genetic determinants, environmental factors, and health behaviors. Especially intra- and interpersonal inactive behaviors, here termed convenience, seems to play an important role. The objective was to develop and validate the Convenience Behavior Questionnaire (CBQ) to assess convenience-related items and their association with overweight and obesity in a large population. A sample of 1233 subjects aged 18-82 years from six population groups took part in a self-administered questionnaire. Test-retest reliability was estimated and the independent association between convenience-related items and overweight and obesity was investigated. Principal component analysis revealed three factors (avoidance behaviors, social interaction behaviors and domestic environmental factors) which explained 43.4% of the variance contributing to the CBQ. Cronbach's α ranged from 0.80-0.89. Test-retest reliability using intra-class correlation was acceptable ≥ 0.70. Forward stepwise logistic regression analysis, including gender, education level, age and TV viewing on weekends showed a positive relation of convenience behavior and overweight (OR: 1.40; 95% CI: 1.01-1.96; P = 0.048), while physical activity status was not significantly associated with overweight (OR: 1.09; 95% CI: 0.77-1.54; P = 0.629). The CBQ seems to be a reliable tool which considers non-traditional behaviors related to overweight development. Interestingly our findings revealed a better relationship between convenience-related behavior with overweight and obesity than the habitual physical activity score.

Refined analysis of the critical age ranges of childhood overweight: implications for primary prevention.

Prevention-interventions would certainly benefit from a precise knowledge of the age range when the most pronounced increases in prevalence of overweight and obesity occur in the general population. Data of 15,662 subjects aged 2-18 years were obtained from a national representative health survey (German Health Interview and Examination Survey for Children and Adolescents (KiGGS)) conducted in Germany. Weight, height, and BMI z-scores were calculated relative to the UK 1990 reference, and prevalence of overweight and obesity was defined according to the IOTF (International Obesity Task Force) age- and sex-specific cut-offs. Univariate ANOVAs for overweight, obesity, weight, height, and BMI z-scores as dependent variables were employed to assess significant differences for these measures across various age levels. Significant analysis was followed by post-hoc comparisons using Bonferroni adjustments. The main effect of age was estimated using a multinomial logistic regression model, and by defining the first derivative of a polynomial spline function. Different eclectic slopes over the entire age range from 2 to 18 years have been observed. Prevalence of overweight substantially increases between the 5th and the 8th year (12.5-21.4%; P ≤ 0.001). Maximum increase of the polynomial fit was detected at 7.2 years. Our findings suggest a relatively narrow age range at the first school year when overweight in German children especially increases. We therefore propose that psychosocial correlates may be related to the general life-time event around the age of entering school.