Kinesiology

Diabetes prevalence is associated with serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D in US middle-aged Caucasian men and women: a cross-sectional analysis within the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial

Kaye E. Brock et al. — Wed, 18 Jan 2012 15:16:15 PST

Hypovitaminosis D may be associated with diabetes, hypertension and CHD. However, because studies examining the associations of all three chronic conditions with circulating 25-hydroxyvitamin D (25(0H)D) and 1,25-dihydroxyvitamin D (1,25(0H)₂D) are limited, we examined these associations in the US Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial (n 2465). Caucasian PLCO participants selected as controls in previous nested case-control studies of 25(0H)D and 1,25(0H)₂D were included in this analysis. Diabetes, CHD and hypertension prevalence, risk factors for these conditions and intake of vitamin D and Ca were collected from a baseline questionnaire. Results indicated that serum levels of 25(0H)D were low (<50nmol/1) in 29% and very low ( < 37nmol/1) in 11% of subjects. The prevalence of diabetes, hypertension and CHD was 7, 30 and 10%, respectively. After adjustment for confounding by sex, geographical location, educational level, smoking history, BMI, physical activity, total dietary energy and vitamin D and Ca intake, only diabetes was significantly associated with lower 25(0H)D and 1,25(0H)₂D levels. Caucasians who had 25(0H)D 2:80nmol/1 were half as likely to have diabetes (OR 0·5 (95% Cl 0·3, 0·9)) compared with those who had 25(0H)D <37 nmol>/l. Those in the highest quartile of 1,25(0H)₂D (<103 pmol>/1) were less than half as likely to have diabetes (OR 0·3 (95% Cl 0·1, 0·7)) than those in the lowest quartile (< 72pmol/l). In conclusion, the independent associations of 25(0H)D and 1,25(0H)₂D with diabetes prevalence in a large population are new findings, and thus warrant confirmation in larger, prospective studies.

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Adolescent Lifestyle Factors and Adult Breast Density in U.S. Chinese Immigrant Women

Marilyn Tseng et al. — Thu, 25 Aug 2011 15:07:50 PDT

We examined recalled measures of adolescent diet, physical activity, and body size in relation to adult breast density in 201 U.S. Chinese immigrant women recruited in January 2002 to May 2003 from Philadelphia region screening programs. Mammographic images were classified into 1 of 4 categories ranging from “entirely fatty” to “extremely dense.” Questionnaires assessed diet and physical activity between ages 12–17, relative weight and height at age 10, and weight at age 18. To estimate odds ratios (ORs), we conducted logistic regression analyses using proportional odds models for polychotomous outcomes. Higher adult breast density was significantly associated with adolescent red meat intake (adjusted 3rd vs. 1st tertile OR= 3.0, 95% confidence interval (CI) 1.5–6.4, trend P=0.003) but not with other adolescent factors. For the association of adult acculturation with breast density, adjustment for adolescent red meat intake attenuated the OR for the highest vs. lowest level of acculturation from 2.5 (95% CI 1.2–5.3) to 1.9 (95% CI 0.9–4.0). Greater adolescent red meat intake may have increased adult breast density and partly accounted for the strong association between acculturation and breast density in this sample of immigrant Chinese women. If confirmed by further study, dietary prevention efforts for breast cancer should be considered earlier in life.

Practitioner Advice and Gestational Weight Gain

Suzanne Phelan et al. — Thu, 25 Aug 2011 15:07:42 PDT

Background: The purpose of this study was to investigate receipt of gestational weight gain advice in prenatal care and ideal and expected gestational weight gain outcomes for normal weight and overweight/obese women.

Methods: This was a cross-sectional study of normal weight (n=203) and overweight/obese (n=198) women in early (<16 >weeks) pregnancy.

Results: Less than half of participants (41.7%) reported receiving weight gain advice from a practitioner. In multivariate models, pregravid weight status was not significantly related to receiving advice. However, women with lower income (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.13-0.77, p=0.01), younger age (OR 0.93, 95% CI 0.87-0.99, p=0.02), and multiparity (OR 0.49, 95% CI 0.28-0.87, p=0.02) were least likely to report receiving advice. Among those receiving advice, most (85%) received accurate advice; however, overweight/obese women were more likely to be advised to overgain compared with normal weight women (22.2% vs. 2.3%, p=0.0001). Overweight/obese women were also more likely than normal weight women to report ideal (OR 7.2, 95% CI 2.3-22.7, p=0.001) and expected (OR 4.7, 95% CI 2.6-8.4, p=0.0001) pregnancy weight gains above Institute of Medicine guidelines. Further, a consistent relationship was observed between higher ideal and expected weight gains and greater first trimester weight gain ( p<0.03).

Conclusions: Clinicians should be encouraged to provide timely and accurate advice to women about gestational weight gain. Interventions to promote healthy gestational weight gain may benefit from targeting women’s beliefs about ideal and expected gestational weight gain.

Physical Activity Patterns Using Accelerometry in the National Weight Control Registry

Victoria A. Catenacci et al. — Thu, 25 Aug 2011 15:07:33 PDT

The National Weight Control Registry (NWCR) was established in 1993 to examine characteristics of successful weight-loss maintainers. This group consistently self-reports high levels of physical activity. The aims of this study were to obtain objective assessments of physical activity in NWCR subjects and compare this to physical activity in both normal-weight and overweight controls. Individuals from the NWCR (n = 26) were compared to a never‑obese normal-weight control group matched to the NWCR group’s current BMI (n = 30), and an overweight control group matched to the NWCR group’s self-reported pre-weight-loss BMI (n = 34). Objective assessment of physical activity was obtained for a 1-week period using a triaxial accelerometer. Bouts of moderate-to-vigorous physical activity (MVPA) ≥10 min in duration, as well as nonbout MVPA (bouts of MVPA 1–9 min in duration) were summed and characterized. NWCR subjects spent significantly (P = 0.004) more time per day in sustained bouts of MVPA than overweight controls (41.5 ± 35.1 min/day vs. 19.2 ± 18.6 min/day) and marginally (P = 0.080) more than normal controls (25.8 ± 23.4). There were no significant differences between the three groups in the amount of nonbout MVPA. These results provide further evidence that physical activity is important for long-term maintenance of weight loss and suggest that sustained volitional activity (i.e., ≥10 min in duration) may play an important role. Interventions targeting increases in structured exercise may be needed to improve long-term weight-loss maintenance.

Dietary energy density and successful weight loss maintenance

Hollie A. Raynor et al. — Thu, 14 Jul 2011 10:12:01 PDT

Research shows a positive relationship between dietary energy density (ED) and body mass index (BMI), but dietary ED of weight loss maintainers is unknown. This preliminary investigation was a secondary data analysis that compared self-reported dietary ED and food group servings consumed in overweight adults (OW: BMI=27–45 kg/m2), normal weight adults (NW: BMI=19–24.9 kg/m2), and weight loss maintainers (WLM: current BMI=19–24.9 kg/m2 [lost≥10% of maximum body weight and maintained loss for ≥5 years]) participating in 2 studies, with data collected from July 2006 to March 2007. Three 24-h phone dietary recalls from 287 participants (OW=97, NW=85, WLM=105) assessed self-reported dietary intake. ED (kcal/g) was calculated by three methods (food+all beverages except water [F+AB], food+caloric beverages [F+CB], and food only [FO]). Differences in self-reported consumption of dietary ED, food group servings, energy, grams of food/beverages, fat, and fiber were assessed using one-way MANCOVA, adjusting for age, sex, and weekly energy expenditure from self-reported physical activity. ED, calculated by all three methods, was significantly lower in WLM than in NW or OW (FO: WLM=1.39±0.45 kcal/g; NW=1.60± 0.43 kcal/g; OW=1.83±0.42 kcal/g). Self-reported daily servings of vegetables and whole grains consumed were significantly higher in WLM compared to NW and OW (vegetables: WLM=4.9±3.1 servings/day; NW=3.9±2.0 servings/day; OW=3.4±1.7 servings/day; whole grains: WLM=2.2±1.8 servings/day; NW=1.4±1.2 servings/day; OW=1.3±1.3 servings/day). WLM self-reported consuming significantly less energy from fat and more fiber than the other two groups. Self-reported energy intake per day was significantly lower in WLM than OW, and WLM self-reported consuming significantly more grams of food/ beverages per day than OW. These preliminary findings suggest that consuming a diet lower in ED, characterized by greater intake of vegetables and whole grains, may aid with weight loss maintenance and should be further tested in prospective randomized controlled trials.

Capstone Experiences: Effects of Adapted Physical Activity Design Projects on Attitudes and Learning

David W. Hey et al. — Tue, 05 Jul 2011 09:51:36 PDT

Eight innovative senior level capstone engineering projects were completed at California Polytechnic State University (2008-present) involving (n=28) students (23 male/5 female). All projects involved the design of equipment to facilitate physical activity for people with disabilities. The effects on: i) learning design, ii) attitude towards people with disabilities, and iii) motivation to complete team design projects were analyzed through eight one-hour focus groups. This paper presents focus group findings using a constructivist approach and grounded theory to explore the overall student “learn by doing” experience. Results: (1) Approximately 19 (70%) of the students claimed the adapted physical activity project was their “first choice” given 60+ projects to rank; (2) Prior to the project only ten (35%) had experience working with people with disabilities and of those students the majority were women; (3) Twenty-six (92.8%) of the students were able to define ‘inclusion’ when asked and viewed the field of engineering as a ‘natural fit’ with project design for adapted physical activity. Students reported high levels of motivation for learning design as evidenced by the majority of engineers getting their “top” choice of projects; (4) Twenty-three (82%) of the engineers would ‘definitely’ consider a future engineering job in this sector and (5) Project challenges included: budget constraints, group communication, fabrication delays, detachment from client, and a desire for increased product testing time. Although students reported high levels of learning and motivation to complete their project; attitudes toward people with disabilities did not change significantly.

What Type of Weight Loss Program Do Postpartum Women Want? Treatment Preferences of Postpartum Women in Two Community Settings

Suzanne Phelan et al. — Tue, 19 Apr 2011 16:05:24 PDT

Approximately 25% of women experience major weight gain after pregnancy, retaining more than 4.5 kg. Preliminary efforts to promote postpartum weight loss have encountered some success, but little is known about the types of programs of greatest interest to postpartum women. The purpose of this study was to better understand the weight control needs and preferences of postpartum women in the Women, Infants and Children (WIC) Nutrition program (N = 100) and an Adult Education Parenting (AEP) program (N = 75). A self-report questionnaire was used to collect participants’ demographic and weight history information as well as participants’ degree of interest in various weight loss treatment modalities. Results indicated that, independent of weeks postpartum and breastfeeding status, women in both groups (WIC and AEO) experienced high postpartum weight retention, and greater weight retention was reported in WIC than AEP (7.6 ± 7.7 kg vs. 3.2 ± 6.9 kg, respectively; p = .0001). When asked about types of weight control treatments, women in both setting expressed greatest interest in weekly face-to-face group meetings, but 66.2% of AEP and 60.6% of WIC reported needing childcare to attend such meetings. Women in both settings reported interest in an Internet-based program, particularly one that integrated monthly face-to-face meetings. Future randomized controlled trials are needed to examine the efficacy of Internet-based treatment in reducing postpartum weight retention in diverse patient populations.

Cognitive Interference From Food Cues in Weight Loss Maintainers, Normal Weight, and Obese Individuals

Suzanne Phelan et al. — Wed, 09 Feb 2011 08:55:02 PST

Much attention has been paid to the behavioral characteristics of successful weight loss maintenance, but less is known about the cognitive processes that underlie this process. The purpose of this study was to investigate cognitive interference from food-related cues in long-term weight loss maintainers (WLM; N = 15) as compared with normal weight (NW; N = 19) and obese (OB; N = 14) controls. A Food Stroop paradigm was used to determine whether successful WLM differed from controls in both the speed and accuracy of color naming words for low-calorie and high-calorie foods. A significant group × condition interaction for reaction time was observed (P = 0.04). In post hoc analyses, no significant differences in reaction time across the three groups were observed for the low-calorie foods (P = 0.66). However, for the high-calorie foods, WLM showed a significantly slower reaction time than the NW (0.04) and OB (0.009) groups (885 ± 17.6, 834 ± 15.8, 816 ± 18.3 ms, respectively). No significant group differences were seen for number of correct trials in 45 s (P = 0.12). The differential interference among WLM did not appear to generalize to other types of distracters (i.e., nonfood). Overall, findings from this study suggest that WLM differ from OB and NW controls in their cognitive responses to high-calorie food cues. Future research is needed to better understand why this bias exists and whether and how interventions can change cognitive processes to better facilitate long-term weight control.