Scott B Going

One aim of the Pathways study is to improve the knowledge, attitudes, and behaviors of American Indian children in grades 3-5 regarding physical activity and diet in. This article describes the development of a culturally sensitive, age-appropriate questionnaire to assess these variables. The questionnaire was designed to be administered in the classroom in two 30-min sessions. Questions were developed to assess 4 key areas: physical activity, diet, weight-related attitudes, and cultural identity. Potential questions were written after review of relevant literature and existing questionnaires. Numerous and extensive revisions were made in response to input from structured, semistructured, and informal data collection. Questions were pretested in 32 children in grades 3-5 by using semistructured interviews. Test-retest reliability and the internal consistency of scales were examined in 371 fourth-grade children and subsequently in 145 fourth-grade children. Questions were reviewed by American Indians from the communities involved in the Pathways study several times during the developmental process. The process described here serves as one model for the development of a culturally appropriate tool to assess knowledge, attitudes, and behaviors in American Indian children.

Abstract:

An understanding of body composition is crucial to understanding human health, disease, and function. Research in body composition has focused on the development of assessment methods, description of normal changes in body composition with growth and development and aging, and the changes that occur in body composition in response to challenges ranging from illness to planned interventions. Each focus is significant, and in a sense, they are interdependent, because technological advances allow more sophisticated questions to be addressed, which in turn drives the development of better methods. Significant advances have been made in each area, although perhaps surprisingly basic questions remain. For example, growth trajectories are often estimated from cross-sectional data, given the resources needed for long-term observational studies, and thus, longitudinal descriptive data are still needed. Along with advances in laboratory methods, development of field methods remains relevant for screening and clinical practice. Despite recognition of wide interindividual differences in intervention response, average outcomes continue to be emphasized. With technological advances, it is now possible to examine genetic along with nongenetic factors that underlie changes in body composition, and these techniques need to be applied in long-term, well-controlled trials. In this article, we review 10 key questions in related areas in which research is needed to continue to advance the field. Copyright © 2014 AAHPERD.

PMID: 18155996;Abstract:

Energy underreporting is a concern with dietary intake data; therefore, subject characteristics associated with underreporting energy intake should be elucidated. Baseline self-reported dietary intake and measures of diet and weight history, life status, weight-loss readiness, psychology, eating behavior, physical activity, and self-image of obese middle-aged women (mean body mass index [calculated as kg/m²]=31.0) enrolled in a lifestyle weight-loss program were evaluated. Of the 155 participating, 71 women were identified as underreporting energy intake using the Goldberg cutoff values. Comparison of means between psychosocial and behavioral measures from energy underreporters and energy accurate reporters were used to help develop logistic regression models that could predict likelihood to underreport energy intake based on baseline measures. Characteristics most predictive of energy underreporting included fewer years of education (P=0.01), less-realistic weight-loss goals (P=0.02), higher perceived exercise competence (P=0.07), more social support to exercise (P=0.04), more body-shape concern (P=0.01), and higher perception of physical condition (P=0.03). These results highlight distinct psychosocial and behavioral characteristics that, at baseline, can help identify the likelihood an overweight middle-aged woman entering a weight-loss intervention will underreport energy intake. These results can help provide a framework for screening study participants for probability of energy underreporting, based on baseline psychosocial and behavioral measures. This knowledge can help researchers target at-risk subjects and, through education and training, improve the accuracy of self-reported energy intake and, ultimately, the accuracy of energy and nutrient intake relationships with health and disease. © 2008 American Dietetic Association.

Abstract:

Background: Rising obesity and declining physical activity levels are of great concern because of the associated health risks. Many children are left unsupervised after the school day ends, but little is known about the association between unsupervised time and physical activity levels. This paper seeks to determine whether adolescent girls who are without adult supervision after school are more or less active than their peers who have a caregiver at home. Methods: A random sample of girls from 36 middle schools at 6 field sites across the U.S. was selected during the fall of the 2002-2003 school year to participate in the baseline measurement activities of the Trial of Activity for Adolescent Girls (TAAG). Information was collected using six-day objectively measured physical activity, self-reported physical activity using a three-day recall, and socioeconomic and psychosocial measures. Complete information was available for 1422 out of a total of 1596 respondents. Categorical variables were analyzed using chi square and continuous variables were analyzed by t-tests. The four categories of time alone were compared using a mixed linear model controlling for clustering effects by study center. Results: Girls who spent more time after school (≥2 hours per day, ≥2 days per week) without adult supervision were more active than those with adult supervision (p = 0.01). Girls alone for ≥2 hours after school, ≥2 days a week, on average accrue 7.55 minutes more moderate to vigorous physical activity (MVPA) per day than do girls who are supervised (95% confidence interval ([C.1]). These results adjusted for ethnicity, parent's education, participation in the free/reduced lunch program, neighborhood resources, or available transportation. Unsupervised girls (n = 279) did less homework (53.1% vs. 63.3%), spent less time riding in a car or bus (48.0% vs. 56.6%), talked on the phone more (35.5% vs. 21.1%), and watched more television (59.9% vs. 52.6%) than supervised girls (n = 569). However, unsupervised girls also were more likely to be dancing (14.0% vs. 9.3%) and listening to music (20.8% vs. 12.0%) (p 05). Conclusion: Girls in an unsupervised environment engaged in fewer structured activities and did not immediately do their homework, but they were more likely to be physically active than supervised girls. These results may have implications for parents, school, and community agencies as to how to structure activities in order to encourage teenage girls to be more physically active. © 2006 Rushovich et al; licensee BioMed Central Ltd.

PMID: 20060079;PMCID: PMC2842480;Abstract:

Understanding the influence of total body fat mass (TBFM) on bone during the peri-pubertal years is critical for the development of future interventions aimed at improving bone strength and reducing fracture risk. Thus, we evaluated the relationship of TBFM to volumetric bone mineral density (vBMD), geometry, and strength at metaphyseal and diaphyseal sites of the femur and tibia of young girls. Data from 396 girls aged 8-13 years from the "Jump-In: Building Better Bones" study were analyzed. Bone parameters were assessed using peripheral quantitative computed tomography (pQCT) at the 4% and 20% distal femur and 4% and 66% distal tibia of the non-dominant leg. Bone parameters at the 4% sites included trabecular vBMD, periosteal circumference, and bone strength index (BSI), while at the 20% femur and 66% tibia, parameters included cortical vBMD, periosteal circumference, and strength-strain index (SSI). Multiple linear regression analyses were used to assess associations between bone parameters and TBFM, controlling for muscle cross-sectional area (MCSA). Regression analyses were then repeated with maturity, bone length, physical activity, and ethnicity as additional covariates. Analysis of covariance (ANCOVA) was used to compare bone parameters among tertiles of TBFM. In regression models with TBFM and MCSA, associations between TBFM and bone parameters at all sites were not significant. TBFM explained very little variance in all bone parameters (0.2-2.3%). In contrast, MCSA was strongly related (p0.001) to all bone parameters, except cortical vBMD. The addition of maturity, bone length, physical activity, and ethnicity did not alter the relationship between TBFM and bone parameters. With bone parameters expressed relative to total body mass, ANCOVA showed that all outcomes were significantly (p0.001) greater in the lowest compared to the middle and highest tertiles of TBFM. Although TBFM is correlated with femur and tibia vBMD, periosteal circumference, and strength in young girls, this relationship is significantly attenuated after adjustment for MCSA. Nevertheless, girls with higher TBFM relative to body mass have markedly diminished vBMD, geometry, and bone strength at metaphyseal and diaphyseal sites of the femur and tibia. © 2010 Elsevier Inc.