Julie Delobelle, Sofie Compernolle, Tomas Vetrovsky, Jelle Van Cauwenberg, Delfien Van Dyck
{"title":"Contexts, affective and physical states and their variations during physical activity in older adults: an intensive longitudinal study with sensor-triggered event-based ecological momentary assessments.","authors":"Julie Delobelle, Sofie Compernolle, Tomas Vetrovsky, Jelle Van Cauwenberg, Delfien Van Dyck","doi":"10.1186/s12966-025-01724-9","DOIUrl":"10.1186/s12966-025-01724-9","url":null,"abstract":"<p><strong>Background: </strong>To design effective tailored interventions to promote physical activity (PA) among older adults, insights are needed into the contexts in which older adults engage in PA and their affective and physical experiences. Sensor-triggered event-based ecological momentary assessment (EMA) is an innovative method for capturing real-life contexts, as well as affective and physical states, during or immediately after specific events, such as PA. This study aimed to (1) describe the physical and social contexts, and the affective and physical states during PA among older adults, (2) evaluate how these constructs fluctuate during PA episodes, and (3) describe affective states during PA according to the context.</p><p><strong>Methods: </strong>An intensive longitudinal sensor-triggered event-based EMA study was conducted with 92 Belgian older adults (65 + years). During seven days, participants were monitored using a Fitbit, which triggered a smartphone-based questionnaire on the event-based EMA platform 'HealthReact' after a five-minute walk. Participants reported on contexts and affective (positive/negative valence) and physical states (pain and fatigue) during the PA event. Descriptive statistics and generalized mixed models were used for data analysis.</p><p><strong>Results: </strong>Older adults predominantly engaged in daily physical activities, such as walking for transport, leisure walking, and gardening, rather than structured exercise. They consistently reported high positive affect, low negative affect, and minimal physical complaints during PA. Furthermore, older adults mainly engage in physical activities alone, particularly in outdoor settings. Variations in contexts, affect, and fatigue were mostly driven by within-subject differences. The model showed significant differences across times of day, with negative affect being highest in the evening and fatigue lowest in the morning. Additionally, the physical and social context influenced negative affect (but not positive affect), with outdoor activities performed alone and indoor activities performed with others being associated with lower negative affect.</p><p><strong>Conclusions: </strong>While these findings could enhance the effectiveness of tailored PA interventions, it remains unclear whether the observed affective and physical states are causes or effects of PA, and whether the contexts in which the activities were performed align with older adults' preferences. Further research is needed to explore these relationships and to better understand older adults' preferred PA contexts.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"30"},"PeriodicalIF":5.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Atle Kongsvold, Eivind Schjelderup Skarpsno, Mats Flaaten, Aleksej Logacjov, Kerstin Bach, Tom Ivar Lund Nilsen, Paul Jarle Mork
{"title":"Associations of sport and exercise participation in adolescence with body composition and device-measured physical activity in adulthood: longitudinal data from the Norwegian HUNT study.","authors":"Atle Kongsvold, Eivind Schjelderup Skarpsno, Mats Flaaten, Aleksej Logacjov, Kerstin Bach, Tom Ivar Lund Nilsen, Paul Jarle Mork","doi":"10.1186/s12966-025-01726-7","DOIUrl":"10.1186/s12966-025-01726-7","url":null,"abstract":"<p><strong>Background: </strong>To examine whether adolescent sport and exercise participation is associated with adulthood moderate-to-vigorous physical activity (MVPA), body fat, skeletal muscle mass, and body mass index (BMI), and to explore whether the association between sport and exercise participation and adult body composition depends on adulthood MVPA level.</p><p><strong>Methods: </strong>Prospective study of 4603 adolescents aged 13-18 year (57.2% female) in the Norwegian Young-HUNT Study and follow-up ~ 11 or ~ 22 years later. Linear regression was used to estimate mean differences in accelerometer-measured MVPA and bioimpedance-measured body fat, muscle mass, and BMI in adulthood according to self-reported sport and exercise participation in adolescence.</p><p><strong>Results: </strong>Adolescents participating in sport/exercise every day accumulated more MVPA (48 min/week, 95% CI 23 to 73), had less body fat (-4.4%, 95% CI -5.4 to -3.2), more muscle mass (2.6%, 95% CI 2.0 to 3.2), and lower BMI (-1.1 kg/m<sup>2</sup>, 95% CI -1.7 to -0.5) as adults, compared to adolescents participating < 1 day/week. Joint analysis showed that adolescents who participated in sport/exercise ≥ 4 days/week, and who accumulated 150-299 min/week MVPA in adulthood, had less body fat (-5.8%, 95% CI -7.4 to -4.3) and more muscle mass (3.4%, 95% CI, 2.5 to 4.3) compared to those participating in sport/exercise ≤ 1 day/week and who accumulated < 150 MVPA min/week as adults. Compared to the same reference group, these associations were further strengthened among those who accumulated ≥ 300 min/week MVPA in adulthood and reported ≥ 4 days/week of sport/exercise for both body fat (-8.8%, 95% CI -10.3 to -7.4) and muscle mass (5.1%, 95% CI 4.3 to 5.9).</p><p><strong>Conclusions: </strong>Adolescent sport and exercise participation is positively associated with MVPA, and skeletal muscle mass, and inversely associated with body fat and BMI in adulthood. These associations remained significant after adjusting for adult MVPA levels. A higher MVPA level in adulthood strengthens the association between adolescent sport/exercise participation and adult body composition.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"29"},"PeriodicalIF":5.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Louise Poppe, Annick L De Paepe, Benedicte Deforche, Delfien Van Dyck, Tom Loeys, Jelle Van Cauwenberg
{"title":"Experience sampling method studies in physical activity research: the relevance of causal reasoning.","authors":"Louise Poppe, Annick L De Paepe, Benedicte Deforche, Delfien Van Dyck, Tom Loeys, Jelle Van Cauwenberg","doi":"10.1186/s12966-025-01723-w","DOIUrl":"10.1186/s12966-025-01723-w","url":null,"abstract":"<p><strong>Background: </strong>The experience sampling method (ESM), also known as ecological momentary assessment, is gaining popularity in physical activity research. This method involves assessing participants' behaviors and experiences repeatedly over time. One key advantage of ESM is its ability to temporally separate the dependent and independent variable of interest, reducing the risk of reverse causality. However, temporal separation alone is insufficient for establishing causality. This methodology paper illustrates the importance of the identification phase in drawing causal conclusions from ESM data. In the identification phase the causal effect of interest (or estimand) is specified and the assumptions under which a statistical association can be considered as causal are visualized using causal directed acyclic graphs (DAGs).</p><p><strong>Methods: </strong>We demonstrate how to define a causal estimand and construct a DAG for a specific ESM research question. The example focuses on the causal effect of physical activity performed in real-life on subsequent executive functioning among older adults. The DAG development process combines literature review and expert consultations to identify time-varying and time-invariant confounders.</p><p><strong>Results: </strong>The developed DAG shows multiple open backdoor paths causing confounding bias, even with temporal separation of the exposure (physical activity) and outcome (executive functioning). Two approaches to address this confounding bias are illustrated: (1) physical control using the within-person encouragement design, where participants receive randomized prompts to perform physical activity in their natural environment, and (2) analytic control, involving assessing all confounding variables and adjusting for these variables in the analysis phase.</p><p><strong>Conclusions: </strong>Implementing the identification phase enables ESM researchers to make more informed decisions, thereby enhancing the validity of causal inferences in studies aimed at answering causal questions.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"28"},"PeriodicalIF":5.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lena Malnes, Tommy Haugen, Emma Charlott Andersson Nordbø, Andreas Ivarsson, Elin Kolle, Geir Kåre Resaland, Runar Barstad Solberg, Andreas Åvitsland, Sveinung Berntsen
{"title":"Objectively measured environmental factors in relation to school travel mode among adolescents: a decision tree analysis.","authors":"Lena Malnes, Tommy Haugen, Emma Charlott Andersson Nordbø, Andreas Ivarsson, Elin Kolle, Geir Kåre Resaland, Runar Barstad Solberg, Andreas Åvitsland, Sveinung Berntsen","doi":"10.1186/s12966-025-01727-6","DOIUrl":"10.1186/s12966-025-01727-6","url":null,"abstract":"<p><strong>Background: </strong>Understanding the factors that influence school travel mode choice is essential for promoting active travel among adolescents. Currently, there is a lack of research that effectively investigates the interactions between demographic and environmental factors on travel behavior. We aimed to investigate the associations between various demographic and environmental characteristics and the choice of school travel modes-walking, cycling, or motorized transport-among adolescents, across the winter and summer seasons.</p><p><strong>Methods: </strong>Data from 1409 Norwegian adolescents, aged 14-15 years, who participated in the School In Motion project were analyzed. Self-reported travel modes and demographic characteristics were collected via questionnaires, while environmental characteristics were determined using Geographic Information Systems (GIS). A decision tree analysis was conducted utilizing the chi-squared automatic interaction detection algorithm to discern patterns in the data. The present study has a cross-sectional design.</p><p><strong>Results: </strong>During summer, the predominant travel modes were cycling (39%), walking (37%), and motorized transport (24%). Gender was associated with travel mode choices over short distances (< 1.6 km), with girls favoring walking and boys favoring cycling. For longer commutes, steep inclines were associated with reduced walking and cycling, while higher traffic exposure was associated with increased cycling. During winter, walking (50%) was the most common mode, followed by motorized travel (36%) and cycling (14%). Living near peers was associated with increased walking and cycling among girls. For commutes exceeding 2 km, factors such as available bus transit, more streetlights, the absence of steep hills, and higher urban centrality were linked to increased walking and cycling.</p><p><strong>Conclusions: </strong>The findings indicated a complex pattern of demographic and environmental factors influencing active travel, with environmental factors becoming increasingly important as commuting distances increased. These findings highlight the importance of considering the interactions of various factors to effectively promote active travel, especially for adolescents undertaking longer commutes.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov ID no: NCT03817047. Registered on: January 25, 2019 (retrospectively registered).</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"26"},"PeriodicalIF":5.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erica E Eberl, Daniel T R Minja, Lise E Lundtoft, Sofie L Moeller, John P A Lusingu, Ib C Bygbjerg, Inge Tetens, Christentze Schmiegelow, Marta Guasch-Ferré, Dirk L Christensen, Ruth J F Loos, Line Hjort
{"title":"Geophagia in pregnancy and its association with nutritional status - A prospective cohort study in rural north-eastern Tanzania.","authors":"Erica E Eberl, Daniel T R Minja, Lise E Lundtoft, Sofie L Moeller, John P A Lusingu, Ib C Bygbjerg, Inge Tetens, Christentze Schmiegelow, Marta Guasch-Ferré, Dirk L Christensen, Ruth J F Loos, Line Hjort","doi":"10.1186/s12966-025-01721-y","DOIUrl":"10.1186/s12966-025-01721-y","url":null,"abstract":"<p><strong>Background: </strong>Geophagia or soil-eating behavior is common among pregnant women in sub-Saharan Africa, however its relationship with nutritional status demands further investigation. Using a prospective pregnancy cohort from north-eastern Tanzania, we examined the characteristics of geophagia and its association with nutritional status parameters (mid-upper arm circumference (MUAC), vitamin B12, folate, ferritin, and hemoglobin) before conception and throughout the gestational period.</p><p><strong>Methods: </strong>Pregnant women (n = 530) were interviewed in each trimester regarding their soil-eating habits. Serum concentrations of vitamin B12, folate, ferritin, and hemoglobin, and MUAC were measured before conception and in each trimester. Cross-sectional comparisons between women who ate and did not eat soil were analyzed using Welch's t-test for continuous variables and χ2-test for categorical variables. The association between changes in nutritional status parameters and the initiation of geophagia was investigated using multivariable logistic regression.</p><p><strong>Results: </strong>The prevalence of geophagia in this cohort was 27% (n = 143) with most women initiating geophagia in the third trimester. Pregnant women that ate soil had significantly lower ferritin (p = 0.001) prior to conception and at concentrations diagnostic of iron deficiency (p = 0.022) compared to women who did not eat soil. Geophagia was associated with lower ferritin (p ≤ 0.001) and lower hemoglobin (p < 0.05) in each trimester and lower folate in the third trimester (p = 0.007). A smaller decline in hemoglobin and folate across the gestational period was associated with reduced odds of initiating geophagia in the third trimester (hemoglobin: OR 0.71, p = 0.008; folate: OR 0.97, p = 0.008). There was no significant association between a change in MUAC, serum B12 or ferritin and the initiation of geophagia during pregnancy.</p><p><strong>Conclusions: </strong>Prenatal geophagia is closely related to iron and folate status. A greater decrease in hemoglobin and folate is associated with the initiation of geophagia during pregnancy. These findings are particularly relevant to low- and middle-income settings where geophagia is practiced and the prevalence of anemia in pregnancy is high.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"27"},"PeriodicalIF":5.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriela Argumedo, Michael W Beets, Jesús Garcés, Fritz Culp, Edgar Denova, Rocío Alvarado-Casas, Anabelle Bonvecchio-Arenas, James F Thrasher, Alejandra Jáuregui
{"title":"I simply have to accompany my parents to sell, nothing else!: a multi-method exploration of barriers and facilitators of extracurricular physical activity among Mexican schoolchildren.","authors":"Gabriela Argumedo, Michael W Beets, Jesús Garcés, Fritz Culp, Edgar Denova, Rocío Alvarado-Casas, Anabelle Bonvecchio-Arenas, James F Thrasher, Alejandra Jáuregui","doi":"10.1186/s12966-025-01716-9","DOIUrl":"10.1186/s12966-025-01716-9","url":null,"abstract":"<p><strong>Background: </strong>The time spent physically active outside of school (e.g., extracurricular physical activity) is an important contributor to children's total daily physical activity for health and well-being. Little is known about the opportunities available to children to engage in extracurricular physical activity from low- to middle-income countries. This study aims to answer the question: What are the main perceived barriers and facilitators of extracurricular physical activity among school-age children in Mexico?</p><p><strong>Methods: </strong>A multi-method cross-sectional study was performed. Six focus groups with children (aged 9-12 years), six focus groups with parents, 10 one-on-one interviews with parents, 12 interviews with teachers, and six interviews with head teachers were conducted across Campeche, Morelos, and Mexico State, Mexico. A questionnaire was applied to explore children's physical activity frequency and preferences for time inside and outside of school. Qualitative data analyses were performed with inductive thematic analysis supported with NVivo software. Quantitative data were analysed with descriptive statistics using IBM SPSS 26.</p><p><strong>Results: </strong>Three main themes summarise the study's findings: (1) how children spend their time outside of school, (2) the places that children access, and (3) the social environment for physical activity outside of the school. The data suggest that children in Mexico dedicate their spare time to screen, work, do housework, or perform unstructured physical activity mostly at home instead of playing sports or actively outdoors. Family support, enjoyment of physical activity, access to programs and facilities, time, living in a housing complex with open common areas, and mild weather were important facilitators identified. 69.4% of children engage in extracurricular physical activity, none of which was provided by schools. More children commute by walking than riding a bike to and from school. Children living inland spent three times more time at home compared to those in seafront areas.</p><p><strong>Conclusions: </strong>Children rely on their families to partake in extracurricular structured physical activity. Policies targeting children's health and well-being should include school-based extracurricular physical activity programs.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"25"},"PeriodicalIF":5.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Physical activity calorie equivalent (PACE) food labelling on discretionary foods in secondary school canteens in England: an efficacy cluster randomised controlled trial.","authors":"Natalia Iris, Fehmidah Munir, Amanda J Daley","doi":"10.1186/s12966-025-01710-1","DOIUrl":"10.1186/s12966-025-01710-1","url":null,"abstract":"<p><strong>Background: </strong>Schools do not typically implement food labelling in their canteens, therefore young people may not be given nutrition information on which to make their food choices. One way of expressing the energy/calorie content of foods is to provide this information in the form of physical activity calorie equivalent (PACE) food labelling, which may help to contextualise the energy content of food/drinks to young people in a simple and understandable way. The study aimed to assess the usefulness of implementing PACE labelling in school canteens and to conduct a process evaluation of using this type of food labelling with young people.</p><p><strong>Methods: </strong>A parallel two-armed cluster RCT to evaluate a PACE labelling intervention in secondary schools (typically, adolescents aged 11 and above) in England was conducted. Schools were randomised on a 2:1 basis to display PACE labelling by cakes/sweet biscuits in canteens or to continue with usual practice (comparator) for up to six weeks. There was a baseline period of no PACE labelling for a minimum of four weeks in all schools. Anonymised purchase data were provided by schools and analysed both descriptively and using analysis of covariance.</p><p><strong>Results: </strong>Eighteen schools in England were randomised and 11 participated (6 intervention and 5 comparators). Analyses are based on ~ 99,000 purchase transactions of cakes and biscuits from participating schools. There was a reduction in cake/biscuit purchases in intervention schools versus comparators of ~ 11 items per week per 100 students at follow-up (adjusted mean difference = -0.112, 95% CI [-0.179 to -0.045], p = 0.005). Intervention schools did not report major difficulties with the implementation of PACE labelling.</p><p><strong>Conclusions: </strong>PACE labelling appeared to reduce cakes/biscuit purchases by a small amount and may be a useful approach to reducing the purchase of discretionary foods in young people in the school environment. The implementation of PACE labelling appeared feasible for some schools, but other schools had reservations about the adverse effects this type of labelling may have on the well-being of students.</p><p><strong>Trial registration: </strong>Registered on ClinicalTrials.gov on 18th November 2022. NCT05623618, https://clinicaltrials.gov/study/NCT05623618 .</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"24"},"PeriodicalIF":5.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ruth Salway, Danielle House, Simona Kent-Saisch, Robert Walker, Lydia Emm-Collison, Alice Porter, David R Lubans, Michael Beets, Frank de Vocht, Russell Jago
{"title":"Designing stepped wedge trials to evaluate physical activity interventions in schools: methodological considerations.","authors":"Ruth Salway, Danielle House, Simona Kent-Saisch, Robert Walker, Lydia Emm-Collison, Alice Porter, David R Lubans, Michael Beets, Frank de Vocht, Russell Jago","doi":"10.1186/s12966-025-01720-z","DOIUrl":"10.1186/s12966-025-01720-z","url":null,"abstract":"<p><strong>Background: </strong>In a stepped wedge design, schools are randomised to a sequence of measurements, with each sequence transitioning to intervention status at a different time. There are several advantages to such designs, including increased statistical power, logistical benefits and the ability to explore change over time. However, stepped wedge designs have not previously been used to evaluate school-based physical activity interventions in children. This paper aimed to explore the feasibility of this design, by identifying school constraints, balancing these with statistical considerations and exploring the power of this chosen design under different scenarios.</p><p><strong>Methods: </strong>We conducted three interlinked studies, with the results from one informing the next. Study 1 was a qualitative study to identify school constraints that inform the choice of stepped wedge configuration. Study 2 used simulation to choose a configuration that balanced these school constraints and statistical properties. Study 3 explored the statistical power for the chosen design for different school and pupil sample sizes, using an open cohort design (a mixture of new and repeated pupils).</p><p><strong>Results: </strong>School staff considered the proposed data collection feasible, and supported a maximum of 3-4 measurements per year and an implementation period of one school term. Study 2 therefore considered incomplete stepped wedge designs with five steps. Statistically, the best designs had a mix of control and intervention measurements in terms 2-4 and a spread of measurements across the whole study duration. Power depended on a combination of the overall recruitment rate and the retention rate. For 20 schools with an eligible class size of 30 pupils, we would be able to detect a 6 min difference in average weekday moderate-to-vigorous physical activity with 80% power, provided there were > 50% of pupils measured per school at each time. A similarly powered cluster randomised controlled trial would require 42 schools.</p><p><strong>Conclusion: </strong>Stepped wedge trials are a viable design for evaluating school-based physical activity interventions. Incomplete designs, where not all schools are measured at each point, offer the flexibility to work around practical constraints.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"22"},"PeriodicalIF":5.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"BMI or not to BMI? debating the value of body mass index as a measure of health in adults.","authors":"Carmen Byker Shanks, Meg Bruening, Amy L Yaroch","doi":"10.1186/s12966-025-01719-6","DOIUrl":"10.1186/s12966-025-01719-6","url":null,"abstract":"<p><p>Body mass index (BMI) is used across public health to calculate height to weight ratio and translate into weight status. Whether BMI is appropriate as an individual- or population-level health measure for adults is debated. BMI is a cost-effective and feasible metric to establish health risk. Yet, BMI's historical underpinnings, weight categories, usefulness as clinical diagnostic measure, and application across population subgroups has called the measurement tool into question. At the annual ISBNPA meeting in June 2023, the co-authors engaged in a debate session on the topic. This paper presents the complexity of arguments for or against BMI as a measurement tool and proposes its evolution to support whole-person health.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"23"},"PeriodicalIF":5.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Is meeting 24-hour movement guidelines associated with a lower risk of frailty among adults?","authors":"Yuhang Liu, Siyao Gao, Zhigang Dou, Zhen Chen, Jialing Tang","doi":"10.1186/s12966-025-01722-x","DOIUrl":"10.1186/s12966-025-01722-x","url":null,"abstract":"<p><strong>Background: </strong>The relationship between 24-hour (24-h) movement guidelines and frailty remains unclear. We aimed to investigate the associations between meeting 24-h movement guidelines and frailty and to conduct secondary analyses by age, gender, and ethnicity.</p><p><strong>Methods: </strong>In this study, we extracted data from the National Health and Nutrition Examination Survey (2007-2018) database. A total of 5,726 participants (50.25 ± 0.31 years) were included in this analysis, representing 38,240,356 noninstitutionalized U.S.</p><p><strong>Individuals: </strong>Three 24-h movement behaviors, namely, physical activity, sedentary behavior (SB), and sleep, were self-reported using the standardized questionnaires. The 49-item frailty index was used to measure frailty. Multivariable logistic regression models and trend tests were used to examine the associations between meeting 24-h movement guidelines and frailty. Sensitivity analyses were also conducted to ensure the robustness of our results.</p><p><strong>Results: </strong>The total age-adjusted prevalence of frailty was 30.5%. In the fully adjusted model, compared with not meeting any of the 24-h movement guidelines, the adjusted odds ratios (AORs) of frailty were 0.786 (95% CI: 0.545, 1.133), 1.161 (95% CI: 0.787, 1.711), and 0.915 (95% CI: 0.616, 1.358) for participants meeting only moderate to vigorous physical activity (MVPA), only SB, and only sleep guidelines, respectively, but no statistically significant differences were observed (all P values > 0.05). Participants who met the SB + sleep guidelines (AOR = 0.613, 95% CI: 0.423, 0.887), MVPA + sleep guidelines (AOR = 0.389, 95% CI: 0.255, 0.593), and MVPA + SB guidelines (AOR = 0.555, 95% CI: 0.383, 0.806) presented a significantly lower risk of frailty by 39%, 61%, and 45%, respectively. Meeting all 3 guidelines (AOR = 0.377, 95% CI: 0.264, 0.539) and meeting 2 guidelines (AOR = 0.527, 95% CI: 0.377, 0.736) were associated with a lower risk of frailty (P value < 0.001), showing a linear trend (P for trend < 0.001). The strength of these associations varied somewhat by age, gender, and ethnicity.</p><p><strong>Conclusions: </strong>Significant associations between the 24-h movement guidelines and frailty were observed among U.S. adults. Future studies are warranted to examine the causality and trajectory of these associations.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"21"},"PeriodicalIF":5.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}