Prevalence of healthy diet and activity behaviours among U.S. Latino preschool children living in an emerging Latino community.

This pilot study provides preliminary insights into whether Latino preschool children living in an emerging Latino community (ELC) are meeting recommendations for healthy diet and activity behaviours and whether those behaviours are associated with sociodemographic or home environment variables. Secondary data analysis was conducted utilising cross-sectional baseline survey data from ANDALE Pittsburgh, a home-based intervention study. Measures included parent-reported information on child dietary intake, screen time and the home environment, and objectively measured physical activity and anthropometry. χ2 and Fischer's exact tests were used to determine associations. The study was conducted in an ELC in western Pennsylvania in the US. Fifty-one Latina mothers (age: 33⋅5 ± 6⋅1 years; 63 % Mexican origin; 86 % low acculturation) and their children (age: 3⋅9 ± 1⋅3 years; 55 % male) 2-5 years of age. On average, children consumed 2⋅25 ± 1⋅44 cups of fruits/vegetables, viewed 98⋅7 ± 74⋅2 min of screen time, accumulated 12⋅9 ± 2⋅9 min/h of total physical activity and consumed 15⋅5 ± 26⋅0 kcals of sugar-sweetened beverages per day. Forty-one percent met the fruit/vegetable recommendation, 54 % met the screen time recommendation, 27 % met the physical activity recommendation and 58 % met the sugary drink recommendation. Country of origin (P = 0⋅032) and acculturation (P = 0⋅048) were significantly associated with children meeting sugary drink recommendations. No other relationships were significant. The proportion of children in this sample meeting diet and activity recommendations was mixed. More research with larger sample sizes is needed in ELCs to identify effective intervention strategies for improving health behaviours.

Paradoxical Associations of Occupational and Nonoccupational Sedentary Behavior With Cardiovascular Disease Risk Measures in Desk Workers.

OBJECTIVES: We assessed sedentary behavior (SB) patterns and examined its associations, by domain, with cardiovascular disease (CVD) risk measures in desk workers ( N = 273). METHODS: Sedentary behavior was measured by activPAL3 and partitioned into occupational and nonoccupational SB. Cardiovascular disease risk measures included blood pressure, pulse wave velocity, heart rate, and heart rate variability. Paired t tests evaluated patterns of SB across domains. Linear regressions estimated associations of occupational and nonoccupational SB with CVD risk measures. RESULTS: Participants spent 69% of their time in SB; higher proportions were accumulated during occupational versus nonoccupational time. Higher all-domain SB was only associated with higher pulse wave velocity. Paradoxically, greater nonoccupational SB unfavorably associated with CVD risk measures, while higher occupational SB favorably correlated to CVD risk measures. CONCLUSIONS: Observed paradoxical associations suggest that domain should be considered in efforts to improve cardiovascular health by reducing SB.

Neighborhood Walkability Is Associated with Physical Activity and Prediabetes in a Behavioral Weight Loss Study: a Secondary Analysis.

BACKGROUND: Socio-environmental factors may affect uptake and utility of behavioral interventions targeting weight loss and cardiometabolic health. To evaluate the relation of neighborhood walkability to physical activity (PA) and glucose control in a sample of adults with overweight/obesity participating in a weight loss study. METHODS: Secondary analysis of a 12-month behavioral weight loss intervention (2011-2015) using one-group pretest-posttest design. Neighborhood walkability was assessed via residential Walk Score (0-100) at study entry. Fasting plasma glucose (FPG) via phlebotomy and PA via waist-worn ActiGraph GT3X were assessed at baseline and end of study. Study variables included neighborhood walkability (car-dependent: Walk Score < 50 vs. walkable: Walk Score ≥ 50), prediabetes (FPG 100-125 mg/dL), and recommended PA (moderate to vigorous PA [MVPA] > 22 min/day). Generalized linear model with logit link results were reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI). RESULTS: The sample (N = 114) was mostly female (88.6%), white (83.3%), college educated (73.7%), and on average 51.4 ± 1.0 years of age. At baseline, persons residing in car-dependent neighborhoods tended to have higher income than those in walkable neighborhoods. Neighborhood walkability interacted with household income at study entry to predict participants' ability to meet the MVPA goal at 12 months (AOR = 13.52, 95% CI: 1.86-119.20). Those from walkable neighborhoods had 67% lower odds of having prediabetes compared to those from car-dependent neighborhoods (AOR = 0.33, 95% CI: 0.10-0.87) at 12 months. CONCLUSION: Our findings corroborate previous research characterizing the relationship between neighborhood walkability, PA, and prediabetes status. Key drivers of this impact warrant further investigation in a study with a larger, more diverse sample.

Impact of weight loss with diet or diet plus physical activity on cardiac magnetic resonance imaging and cardiovascular disease risk factors: Heart Health Study randomized trial.

OBJECTIVE: The primary aim of this study was to examine the change in left ventricular mass (LVM) in adults with overweight or obesity in response to a behavioral weight-loss intervention, with variable physical activity (PA) prescriptions. METHODS: A total of 383 adults were randomized to a 12-month intervention of diet modification (DIET), DIET plus 150 min/wk of PA (DIET+MODPA), or DIET plus prescription of 250 min/wk of PA (DIET+HIGHPA). LVM was measured with cardiac magnetic resonance imaging. RESULTS: Twelve-month weight loss was -10.2% (95% CI: -11.7% to -8.8%) in the DIET group, -11.0% (95% CI: -12.4% to -9.5%) in the DIET+MODPA group, and -10.3% (95% CI: -11.8% to -8.9%) in the DIET+HIGHPA group. LVM decreased at 12 months in the DIET group (-2.9 g [95% CI: -5.2 to -0.7]; p = 0.0114), with no change observed in the DIET+MODPA group (-0.8 g [95% CI: -3.0 to 1.5]; p = 0.4979) or the DIET+HIGHPA group (-1.1 g [95% CI: -3.3 to 1.1]; p = 0.3299). CONCLUSIONS: Weight loss through dietary modification resulted in reduced LVM, whereas, when combined with at least 150 min/wk of prescribed moderate-to-vigorous PA, LVM was preserved. These may both be favorable adaptations to weight loss and PA in adults with overweight or obesity that warrant further investigation to understand the clinical implications of these changes on cardiovascular disease risk.

The feasibility and acceptability of a web-based physical activity for the heart (PATH) intervention designed to reduce the risk of heart disease among inactive African Americans: Protocol for a pilot randomized controlled trial.

BACKGROUND: Many studies have used the internet to promote physical activity (PA) in several settings, including the home environment, but few have been tailored for African Americans (AAs). To address this research gap, we conducted focus groups with AAs to inform the development of a web-based intervention, Physical Activity for The Heart (PATH), that leverages openly accessible platforms, such as YouTube, to promote PA in any setting. PURPOSE: To describe the rationale and design of a pilot randomized clinical trial (RCT), that examines the feasibility and acceptability of the PATH intervention among 30 AA adults aged 40--70 years without history of cardiovascular disease. METHODS: A 12-week, single-site, wait-listed RCT with subjects randomized 1:1 to either: 1) treatment group - participants receive the PATH intervention, including the online portal and twice a month phone calls from a PA coach, or 2) attention control group - participants receive a self-help PA handout and twice a month general health newsletter. All participants self-monitor step count using actigraphy. The primary outcomes of this 12-week, pilot RCT are recruitment, retention, and adherence to self-monitoring (Actigraph wear time) and the intervention protocol (PATH utilization). The secondary outcomes include changes in PA (step count, moderate-to-vigorous PA, exercise self-efficacy), and cardiometabolic risk (HbA1C, HDL, LDL, total cholesterol, type 2 diabetes risk score, percent body fat, weight, and waist circumference) from baseline to 12 weeks. CONCLUSIONS: This study will provide PATH intervention feasibility and acceptability data among inactive AA adults and will inform a future, full-scale RCT testing efficacy.

Vicarious Experience in Multi-Ethnic Study of Atherosclerosis (MESA) Is Associated with Greater Odds of Attaining the Recommended Leisure-Time Physical Activity Levels.

BACKGROUND: Social cognitive theory posits that observing similar others succeed (i.e., vicarious experience) can improve self-efficacy. However, there are very limited data on the utility of vicarious experience in promoting physical activity (PA). This analysis examined the association between vicarious experience and leisure-time PA (LTPA) in the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS: Cross-sectional analysis of MESA participants who completed exam 5. LTPA and neighborhood factors were self-reported. Neighborhood factors were converted into aesthetic, walking, and safety scores. Group comparative analyses evaluated differences in variables of interest. The relationship between vicarious experience and recommended LTPA (≥ 7.5 MET-h/week) was assessed via logistic regression. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) are reported. RESULTS: Participants (N = 4579) were older (69.7 ± 9.4 years), 53% female, 41% Caucasian, 26% Black, 21% Hispanic, and 12% Chinese. Those who reported vicarious experience had 45% (95% CI 1.16-1.81) greater odds of attaining recommended LTPA. Unfavorable walking score was associated with lower odds of attaining recommended LTPA (OR = 0.89, 95% CI 0.79-1.00). The aesthetic and safety scales were not associated with LTPA (OR = 1.00 [95% CI 0.89-1.13] and OR = 0.91 [95% CI 0.82-1.10], respectively). CONCLUSIONS: Programs exposing community-dwelling adults to peers engaging in PA could provide an effective public health approach to increase community-level PA participation.

Recommendations for a Culturally Salient Web-based Physical Activity Program for African Americans.

BACKGROUND: Barriers to physical activity (PA) among African Americans (AAs) have been extensively studied, yet there is limited research on innovative PA interventions designed to address them. In recent years, many studies have used the internet to promote PA, but very few have included AAs. In this study, we sought the input of AA focus groups to inform the development of a web-based Physical Activity for The Heart (PATH) program for inactive AAs. METHODS: A qualitative design involving 4 focus groups stratified by sex and age was employed to explore AAs' needs and preferences for resources to be included in the PATH program. We employed an inductive approach to content analysis to analyze data using ATLAS.ti 7.5. RESULTS: Sixteen women and ten men (age 30-65 years) participated in the focus groups. Participants were obese (mean BMI 32.2 ± 5.4 kg/m2) with below average confidence rating (mean 46.4 ± 19.1%) on the Barriers Self-Efficacy Scale. Three main themes emerged from the data: 1) need to see similar others engaging in PA (workout videos featuring models with relatable body size, age, ethnicity), 2) flexible PA regimen (doable at any time/setting), and 3) age and sex differences in preferences for PA resources (religion, music, intensity). CONCLUSION: These data suggest that specific intervention components, i.e., PA models who match participants' profiles, flexibility and tailoring to age/gender groups, could improve uptake of web-based PA programs designed for inactive AAs. Therefore, a precision health approach needs to be employed when designing interventions to promote PA among inactive AAs.

Effect of mindfulness meditation on short-term weight loss and eating behaviors in overweight and obese adults: A randomized controlled trial.

Background There is a significant health crisis with rates of obesity continuing to increase despite research and clinical standard behavioral weight loss programs (SBWP). Mindfulness meditation (MM), with demonstrated benefits on physical, psychological health, and self-regulation behaviors was explored with SBWP. Methods Forty-six adults (BMI=32.5±3.7 kg/m2; age=45.2±8.2 years, 87 % female, 21.7 % African American) were randomly assigned to a 6-month SBWP only (n=24) or SBWP+MM (n=22) at a university-based physical activity and weight management research center in a northeastern US city. Participants were instructed to decrease intake (1200-1500 kcal/day), increase physical activity (300 min/wk), and attend weekly SBWP or SBWP+MM sessions. SBWP+MM had the same SBWP lessons with addition of focused MM training. Outcome measures collected at 0, 3, and 6 months included: weight, Block Food Frequency Questionnaire, Eating Behavior Inventory, Eating Inventory and Paffenbarger Physical Activity Questionnaire. Data were analyzed using linear mixed modeling for efficacy analysis of weight (primary) and eating, exercise and mindfulness (secondary outcomes). Results Retention rate was 76.1 % (n=35). A significant group by time interaction (p=0.03) was found for weight, with weight loss favoring SBWP+MM (-6.9 kg+2.9) over SBWP (-4.1 kg+2.8). Eating behaviors (p=0.02) and dietary restraint (p=0.02) improved significantly in SBWP+MM, compared to SBWP. MM enhanced weight loss by 2.8 kg potentially through greater improvements in eating behaviors and dietary restraint. Conclusions These findings support further study into the use of MM strategies with overweight and obese adults. The use of this low-cost, portable strategy with standard behavioral interventions could improve weight management outcomes.

Study Protocol for a Home-based Obesity Prevention Program in Latino Preschool Children.

PURPOSE: This paper describes the study design for ANDALE Pittsburgh, a culturally-appropriate, family-based intervention to promote a healthy weight in Latino preschool children. METHODS/DESIGN: The study was organized into two major phases: Phase I: Conduct focus groups with 30 Latino parents of preschool children to inform the development of a culturally-appropriate intervention; Phase II: Test the feasibility and effectiveness of the intervention with 50 families. Participants were recruited from an emerging Latino community through community gatherings, flyers, and word of mouth. Six promotoras (females >18 years, active in community) received 25 hours of training using the intervention curriculum finalized after Phase I. Promotoras delivered the home-based intervention to families over 10, 90-minute weekly sessions that included education, practice, and action (i.e., goal setting). Behavior modification constructs and strategies (e.g., goal setting, problem solving, social support), and building of self-efficacy through healthy recipe preparation and physical activity breaks, were also included. Outcomes (e.g., child BMI) were assessed pre- and post-intervention. Process evaluation assessed fidelity, dose, reach, recruitment, and contextual factors using multiple data sources and mixed methods. DISCUSSION: The ANDALE Pittsburgh study will expand the body of knowledge on interventions to promote a healthy weight in Latino preschool children living in an emerging Latino community. If successful, this approach will be evaluated in a future, larger-scale intervention and provide a potential model to help to address and prevent obesity in this population.

Reliability and Accuracy of a Standardized Shallow Water Running Test to Determine Cardiorespiratory Fitness.

A standardized fitness assessment is critical for the development of an individualized exercise prescription. Although the benefits of aquatic exercise have been well established, there remains the need for a standardized nonswimming protocol to accurately assess cardiorespiratory fitness (CRF) in shallow water. The present investigation was designed to assess (a) the reliability of a standardized shallow water run (SWR) test of CRF and (b) the accuracy of a standardized SWR compared with a land-based treadmill (LTM) test. Twenty-three healthy women (20 ± 3 years), with body mass index (23.5 ± 3 kg·m), performed 2 shallow water peak oxygen consumption (V[Combining Dot Above]O2peak) running tests (SWRa and SWRb), and 1 V[Combining Dot Above]O2max LTM. Intraclass correlation coefficients indicated moderately strong reliability for V[Combining Dot Above]O2peak (ml·kg·min) (r = 0.73, p < 0.01), HRpeak (b·min) (r = 0.82; p < 0.01), and O2pulse (V[Combining Dot Above]O2 [ml·kg·min]·HR [b·min]) (r = 0.77, p < 0.01). Using paired t-tests and Pearson's correlations, SWR V[Combining Dot Above]O2peak and HRpeak were significantly lower than during LTM (p ≤ 0.05) and showed moderate correlations of 0.60 and 0.58 (p < 0.001) to LTM. O2pulse was similar (p > 0.05) for the SWR and LTM tests with a moderate correlation of 0.63. A standardized SWR test as a measure of CRF is a reliable, and to some degree, valid alternative to conventional protocols and may be used by strength and conditioning professionals to measure program outcomes and monitor training progress. Furthermore, this protocol provides a water-based option for CRF assessment among healthy women and offers insight toward the development of an effective protocol that can accommodate individuals with limited mobility, or those seeking less musculoskeletal impact from traditional land-based types of training.

Association of the degree of adiposity and duration of obesity with measures of cardiac structure and function: the CARDIA study.

OBJECTIVE: Examine whether there are independent influences of a greater degree of adiposity and longer duration of obesity on cardiac structure and function. METHODS: Participants of CARDIA were 18-30 years when they underwent a baseline examination in 1985-86. Seven follow-up examinations were conducted every 2-5 years. RESULTS: Among 2,547 participants who underwent an echocardiogram at the year 25 examination and were not obese at baseline, 34.4 and 35.5% were overall (BMI ≥ 30 kg m(-2) ) and abdominally obese (waist circumference: men: >102 cm; women: >88 cm) at year 25, respectively. A greater degree of overall and abdominal adiposity at year 25 were each associated with a greater left ventricular (LV) mass (P < 0.001), LV volume (P < 0.001), LV mass-to-volume ratio (P < 0.001), left atrial dimension (P < 0.001), and ejection fraction (P < 0.05) after adjustment for duration of obesity and other risk factors. In contrast, a longer duration of overall obesity was associated with a greater LV mass (P = 0.003) and a trend for a lower ejection fraction (P = 0.07). CONCLUSIONS: A greater degree of adiposity is strongly associated with concentric LV remodeling in midlife, while the cumulative effects of a longer duration of overall obesity during young adulthood contribute to concentric remodeling predominantly by increasing LV mass.

Prognostic value of sentinel lymph node biopsy compared with that of Breslow thickness: implications for informed consent in patients with invasive melanoma.

BACKGROUND: Sentinel lymph node (SLN) status is reportedly a powerful prognosticator of survival. Breslow thickness alone provides significant prognostic information. OBJECTIVE: To assess overall survival (OS) according to tumor depth based on SLN status. MATERIALS AND METHODS: MEDLINE, EMBASE, and the Cochrane Central Database were searched for studies. Included studies evaluated overall survival according to SLNB results and were stratified according to Breslow thickness. Meta-analysis was performed if appropriate in each category for which three or more studies reported risk estimates and variability measurement. RESULTS: Twenty-nine articles met inclusion criteria. Six met the criteria for meta-analysis. In individuals with thin melanoma (<1 mm), SLN-negative status conferred no survival advantage (sign test, p > .99). Few studies were available for intermediate depths, and most reported worse survival in SLN-positive patients, although the difference was not statistically significant (p > .05). For thick melanoma (>4 mm), SLN positivity was related to worse prognosis (sign test, p = .004). Based on the pooled results of six studies of patients with tumors 4 mm thick or thicker, SLN-positive patients had a greater likelihood of dying (hazard ratio = 2.42, 95% confidence interval = 2.00-2.92). CONCLUSIONS: Sentinel lymph node biopsy may not provide more-accurate prognostic information than Breslow thickness for most melanomas.