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The Exercise is Medicine On Campus (EIM-OC) program began in 2009 at Chatham University by Dr. Robert Sallis, Dr. Carena Winters, and ACSM leadership. The vision of EIM-OC is "to see all campus and community members across multiple disciplines discover, share, and adopt the principles of EIM that will help change the culture of physical activity and chronic disease prevention and management campus wide." Although EIM-OC maintains close track of programmatic details, such as the number of registered and recognized institutions, a comprehensive review of EIM-OC publications has not been previously reported. The purpose of this scoping review was to 1) identify and examine all peer-reviewed evidence of EIM-OC, including scholarly articles and published abstracts of presentations; 2) analyze the key themes of EIM-OC implementation and outcomes; and 3) identify gaps in the literature. The scoping review covered all peer-reviewed publications, including scholarly articles and published abstracts, from 2009 to December 2021. In total, 9 scholarly articles and 46 published abstracts were included in this review. The articles and abstracts covered a wide range of topics, including gold level (physical activity assessment and exercise referral), silver level (physical activity education), and bronze level (physical activity awareness and promotion) activities, as well as evaluation of EIM-OC programming. Now that EIM-OC programming is firmly established, we now call on campuses and leaders to strengthen their reporting of EIM-OC outcomes at all levels: gold, silver, and bronze. Publishing research evidence will strengthen EIM-OC programming and initiatives. Specifically, we encourage publishing scholarly articles and using broad means for increasing dissemination.

This study evaluates if the Kiddie Children and Teachers on the Move physical activity (PA) program improves the proportion of days meeting the Institute of Medicine (IOM) PA guideline, and whether meeting the guideline is correlated with improvement in school readiness. Thirteen Head Start-affiliated pre-kindergarten classrooms participated in this study. Minutes per hour of moderate-to-vigorous physical activity (MVPA) and proportion of days meeting the IOM PA guideline were examined across three types of intervention days: days during a non-intervention period, non-program days during the intervention period, and program days during the intervention period. Children displayed increasingly more MVPA and a greater proportion of days meeting the IOM guideline from non-intervention days to non-program days, and from non-program days to program days. Proportion of days meeting the guideline significantly predicted improvement in school readiness in five of six domains. Examination of program fidelity indicated the program was run with high fidelity.

As more schools begin to include preschool classrooms, teachers and administrators may need physical activity (PA) curricula that are inclusive, specially designed for young children, and linked to...

Background: According to the US Institute of Medicine guideline, preschool-aged children should participate in ≥15 minutes of physical activity (PA) per hour or 3 hours per day over 12 hours. Examinations of PA guideline compliance to date averaged time spent in PA over several days; however, children could exceed the guideline on some days and not on others. Therefore, this cross-sectional study examined PA guideline compliance in preschool children based on number of minutes per hour (average method) and percentage of days the guideline was met (everyday method). Methods: PA was measured by accelerometry during the preschool day for up to 10 days in 177 children (59.3% males, Mage = 4.23). Minutes per hour and percentage of time in light, moderate to vigorous, and total PAs were calculated. Percentage of days in compliance was determined by number of days in compliance (defined as the child active on average ≥15 min/h) divided by total accelerometer days. Results: Children engaged in PA, on average, 17.01 minutes per hour, suggesting that on average, children are meeting the guideline. However, children were only in compliance with the PA guideline 62.41% of assessment days. Conclusions: Findings demonstrate the importance of examining compliance with both the average and everyday methods to more accurately portray level of Institute of Medicine PA guideline compliance.

Objectives The aim of this study was to evaluate the accuracy of three consumer-based activity monitors, Fitbit Charge 2, Fitbit Alta, and the Apple Watch 2, all worn on the wrist, in estimating step counts, moderate-to-vigorous minutes (MVPA), and heart rate in a free-living setting. Methods Forty-eight participants (31 females, 17 males; ages 18–59) were asked to wear the three consumer-based monitors mentioned above on the wrist, concurrently with a Yamax pedometer as the criterion for step count, an ActiGraph GT3X+ (ActiGraph) for MVPA, and a Polar H7 chest strap for heart rate. Participants wore the monitors for a 24-hour free-living condition without changing their usual active routine. MVPA was calculated in bouts of ≥10 minutes. Pearson correlation, mean absolute percent error (MAPE), and equivalence testing were used to evaluate the measurement agreement. Results The average step counts recorded for each device were as follows: 11,734 (Charge2), 11,922 (Alta), 11,550 (Apple2), and 10,906 (Yamax). The correlations in steps for the above monitors ranged from 0.84 to 0.95 and MAPE ranged from 17.1% to 35.5%. For MVPA minutes, the average were 76.3 (Charge2), 63.3 (Alta), 49.5 (Apple2), and 47.8 (ActiGraph) minutes accumulated in bouts of 10 or greater minutes. The correlation from MVPA estimation for above monitors were 0.77, 0.91, and 0.66. MAPE from MVPA estimation ranged from 44.7% to 55.4% compared to ActiGraph. For heart rate, correlation for Charge2 and Apple2 was higher for sedentary behavior and lower for MVPA. The MAPE ranged from 4% to 16%. Conclusion All three consumer monitors estimated step counts fairly accurately, and both the Charge2 and Apple2 reported reasonable heart rate estimation. However, all monitors substantially underestimated MVPA in free-living settings.

This study evaluates if the Kiddie Children and Teachers on the Move physical activity (PA) program improves the proportion of days meeting the Institute of Medicine (IOM) PA guideline, and whether meeting the guideline is correlated with improvement in school readiness. Thirteen Head Start-affiliated pre-kindergarten classrooms participated in this study. Minutes per hour of moderate-to-vigorous physical activity (MVPA) and proportion of days meeting the IOM PA guideline were examined across three types of intervention days: days during a non-intervention period, non-program days during the intervention period, and program days during the intervention period. Children displayed increasingly more MVPA and a greater proportion of days meeting the IOM guideline from non-intervention days to non-program days, and from non-program days to program days. Proportion of days meeting the guideline significantly predicted improvement in school readiness in five of six domains. Examination of program fidelity indicated the program was run with high fidelity.

Objective To objectively determine the prevalence of overweight and obesity in elementary school children in two rural counties in Vermont prior to implementing a community-based intervention. Methods School-based objective measures of body mass index (BMI) were obtained from 1,688 public school children in first, third, and fifth grades in two Northern Vermont counties in the Fall of 2017. Results Forty-one percentage of elementary school children were either overweight or obese, nearly double the estimated Vermont prevalence rate of 22.2%. Schools located in more rural areas showed higher levels of overweight and obesity in children than schools in less rural areas in these northern counties (p Conclusions Indirect and self-reported measures of BMI may be underestimating the true prevalence of overweight and obesity particularly in more rural communities. Policy implications Data presented here in which children were measured directly by trained study staff demonstrate that the prevalence of obesity among children in elementary school is alarmingly high. Accurate, ongoing BMI measurement surveillance is one tool to better understand both the current trends in childhood overweight and obesity and the effect of community and state interventions.

Background Preschool ADHD symptoms have predictive utility for later presence of ADHD diagnoses (Harvey, Youngwirth, Thakar, & Errazuriz, 2009, Journal of Consulting and Clinical Psychology, 77, 349; Lahey et al., 2004, American Journal of Psychiatry, 161(11), 2014), yet some level of inattention, hyperactivity, and impulsivity are present even in typically developing preschoolers. Physical activity (PA) is known to have a broad spectrum of positive effects on the brain in school-age typically developing children (Centers for Disease Control and Prevention, 2010, The association between school based physical activity, including physical education, and academic performance. Atlanta, GA: U.S. Department of Health and Human Services), including functions impaired by ADHD (Halperin, Berwid, & O'Neill, 2014, Child and Adolescent Psychiatric Clinics of North America, 23, 899), yet links between PA and ADHD levels and impairments have rarely been studied in either typically developing or at-risk preschool children. Importantly, impaired processing speed (PS), though not a symptom of ADHD, is a robust neuropsychological correlate (Willcutt & Bidwell, 2011, Treating attention deficit hyperactivity disorder: Assessment and intervention in developmental context. Kingston, NJ: Civic Research Institute) that may indicate additional risk for ADHD. Hence, we examined whether baseline PS moderates the association between preschoolers' PA, specifically moderate-to-vigorous PA (MVPA), and changes in ADHD levels and related behaviors. Method Eighty-five preschoolers (49.4% female; Mage = 4.14, SDage = .64) were drawn from a larger study of the effects of the Kiddie Children and Teachers (CATs) on the Move PA program on school readiness. The sample was largely Head Start eligible (68.2%) and ethnically diverse. Hierarchical regressions were utilized to examine links between MVPA, averaged over a school year, and changes in inattention (IA), hyperactivity/impulsivity (HI), oppositional behaviors, moodiness, and peer functioning, and whether these associations varied based on baseline PS. Results Results indicated that for IA, HI, and peer functioning, higher amounts of MVPA were associated with greater adaptive change for those with lower (but not higher) levels of PS. Conclusions Preschool MVPA may be a viable method of reducing ADHD levels and impairments for those with lower PS.

Findings from studies of food addiction in adults suggest those with food addiction are less successful in weight-loss interventions. Little is known about food addiction in obesity treatment-seeking adolescents; therefore, the purpose of this study was to explore the prevalence of food addiction and correlates of food addiction symptoms in obese adolescents entering an outpatient, weight management program.Obese adolescents (n = 26) were administered the Yale Food Addiction Scale for Children (YFAS-C), measures of appetitive responsiveness, and health-related quality of life (HRQOL) before and following a 12-week, outpatient, behavioral weight management program. Descriptive statistics and correlations between YFAS-C symptoms and study variables were performed and further examined with linear regression. Baseline differences were compared between those meeting criteria for food addiction to those who did not (independent t-tests) and pre-postweight management program changes were examined (paired t-tests).30.7% met criteria for food addiction and 50% reported ≥3 symptoms. Number of YFAS-C symptoms was correlated with appetitive responsiveness (r = 0.57, p 0.05) and inversely correlated with all domains of HRQOL (r = 0.47-0.53, p 0.05). Attrition rate was higher in adolescents with food addiction compared to those without (62.5% vs. 44.4%, p 0.05).Adolescents with food addiction or with a higher number of food addiction symptoms may warrant additional resources to support adherence to and retention with a weight management program. Implementing screening measures for food addiction before enrolling in a weight management program may be an effective strategy to identify adolescents who may benefit from adjunct modalities.

If a parent does not accurately perceive their child’s overweight or obese status and potential health risk as a result of excess weight, they may be less inclined to encourage their child’s participation in healthy behaviors. This study systematically reviewed the past 5 years of literature regarding the accuracy of parental perception of their child’s weight status. PubMed, PsychInfo, and CINAHL databases from 2006 to 2012 were searched using key words related to parental perception and childhood overweight. Quantitative studies which assessed parental perception of their child’s body weight with height and weight measurements of the child (2–18 years of age) within the United States were included. Studies were excluded if the family was preparing to or currently receiving any kind of treatment or intervention for weight loss/management. Eligible articles which assessed and reported parental perception of their child’s body weight. Thirteen studies met the criteria for inclusion. Underestimation of obesity ranged from 13.3 to 100 % of parents of children with a BMI ≥95th percentile. In six of the studies, >70 % of parents of overweight children (≥85–

Background: The Western diet increases risk of metabolic disease. Objective: We determined whether lowering the ratio of saturated fatty acids to monounsaturated fatty acids in the Western diet would affect physical activity and energy expenditure. Design: With the use of a balanced design, 2 cohorts of 18 and 14 young adults were enrolled in separate randomized, double-masked, crossover trials that compared a 3-wk high–palmitic acid diet (HPA; similar to the Western diet fat composition) to a low–palmitic acid and high–oleic acid diet (HOA; similar to the Mediterranean diet fat composition). All foods were provided by the investigators, and the palmitic acid (PA):oleic acid (OA) ratio was manipulated by adding different oil blends to the same foods. In both cohorts, we assessed physical activity (monitored continuously by using accelerometry) and resting energy expenditure (REE). To gain insight into a possible mood disturbance that might explain changes in physical activity, the Profile of Mood States (POMS) was administered in cohort 2. Results: Physical activity was higher during the HOA than during the HPA in 15 of 17 subjects in cohort 1 (P = 0.008) (mean: 12% higher; P = 0.003) and in 12 of 12 subjects in the second, confirmatory cohort (P = 0.005) (mean: 15% higher; P = 0.003). When the HOA was compared with the HPA, REE measured during the fed state was 3% higher for cohort 1 (P < 0.01), and REE was 4.5% higher in the fasted state for cohort 2 (P = 0.04). POMS testing showed that the anger-hostility score was significantly higher during the HPA (P = 0.007). Conclusions: The replacement of dietary PA with OA was associated with increased physical activity and REE and less anger. Besides presumed effects on mitochondrial function (increased REE), the dietary PA:OA ratio appears to affect behavior. The second cohort was derived from a study that was registered at clinicaltrials.gov as R01DK082803.

Cystic fibrosis (CF) clinical care guidelines exist for the care of infants up to age 2 years and for individuals ≥6 years of age. An important gap exists for preschool children between the ages of 2 and 5 years. This period marks a time of growth and development that is critical to achieve optimal nutritional status and maintain lung health. Given that disease often progresses in a clinically silent manner, objective and sensitive tools that detect and track early disease are important in this age group. Several challenges exist that may impede the delivery of care for these children, including adherence to therapies. A multidisciplinary committee was convened by the CF Foundation to develop comprehensive evidence-based and consensus recommendations for the care of preschool children, ages 2 to 5 years, with CF. This document includes recommendations in the following areas: routine surveillance for pulmonary disease, therapeutics, and nutritional and gastrointestinal care.

Physical activity is a proven form of diabetes management and is considered a cornerstone in the prevention of diabetes. In children with diabetes, physical activity may improve insulin sensitivity and glucose uptake in skeletal muscle. Aerobic-based physical activity lasting 40-60 minutes daily for a minimum of four months is shown to enhance insulin sensitivity, and may reduce the risk for type 2 diabetes. An important adjunct to aerobic-based physical activity for diabetes prevention is resistance training. The American Academy of Pediatrics supports properly supervised strength/resistance training as a safe method for strength development in preadolescent children. Resistance training may increase skeletal muscle mass, therefore increasing whole-body glucose disposal capacity. In addition to immediate health benefits during childhood, increased physical activity in children and adolescents is likely to contribute to the establishment of healthy leisure habits over a lifetime and improved adult...

1) Report the feasibility of completing the 180-minute Frequently Sampled Intravenous Glucose Tolerance Test (FSIVGTT) in healthy weight, overweight and obese pre-pubertal children and, 2) describe the finalized FSIVGTT protocol after addendums were implemented to decrease the frequency of mild adverse events and improve test completion rates.Insulin sensitivity was determined by FSIVGTT.FSIVGTT was attempted in a total of 22 study participants. Insulin sensitivity was successfully assessed in 15 study participants (8 males, 7 females, 10 Caucasian, 4 African American, 1 Pacific Islander, age range 7-9 years). Mean insulin sensitivity was 15.1+/-9.8 (mmicro/l)(-1) min(-1) range 4.4-43.2 (mmicro/l)(-1) min(-1). However, seven study participants experienced mild adverse events of hypoglycemia. Several addendums were made to the FSIVGTT protocol to ensure study participants' comfort and safety, and to decrease the frequency of mild adverse events and increase test completion rates.Addendums made to FSIVGTT protocol allowed successful completion of FSIVGTT in 15 (68%) of the 22 children. These results demonstrate that FSIVGTT is challenging, yet feasible in healthy lean and obese pre-pubertal children.

Purpose The purpose of this study was to explore the experience of health care providers (HCPs) in the outpatient setting as they work with fathers of children who are overweight and obese. Method Interpretative phenomenological analysis was used for data collection and analysis. Seven HCPs were interviewed about their experiences. Results Two major themes emerged from the experiences of these HCPs: “dad in the back seat” and “paternal resistance.” Discussion The theme of “dad in the back seat” captured the HCPs' experiences and perceptions of parental roles and related stereotypes with respect to fathers' lack of presence in the health-care setting, family roles that relegate fathers to the back seat in dealing with this issue, and the tendency of fathers to take a passive role and defer to mothers in the management of their child's weight. “Paternal resistance” reflected the perceived tendency of the father to resist the acceptance of his child's weight as a problem and to resist change and even undermine family efforts to make healthier choices. Conclusion HCPs' experiences of fathers as having a minimal role in the management of their child's overweight and obesity may lead them to neglect fathers as agents of change with regard to this important issue.

Background:Compared with structured/organized activities, unstructured, self-selected physical activity (PA) may be more appealing for children in particular obese (OB) children. We examined whether both healthy-weight (HW) and OB children would engage in moderate to vigorous intensity PA during an unstructured PA program and compared heart rate (HR) and rate of perceived exertion (RPE) between the children.Methods:Twenty-one children [9 OB (≥95th BMI percentile, 12 HW (5th – Results:Mean HR ≥ vigorous THR for all children in 65.3% of the sessions and exceeded moderate intensity in 100%. Over the 18-weeks, no significant difference was observed in the overall mean HR between the HW (171.4 ± 12.0) and OB (169.3 ± 13.0), however the OB reported significantly lower RPEs than the HW (16.9 ± 2.6 vs. 17.6 ± 1.5, respectively; P < .05).Conclusions:Both the HW and OB children consistently sustained PA of moderate and vigorous intensity. The current study provides insight regarding the physiological capabilities and perceptual responses of HW and OB children participating in PA programs.

Background Physical inactivity has been deemed a significant, contributing factor to childhood overweight and obesity. In recent years, many school systems removed recess and/or physical education from their curriculum due to growing pressure to increase academic scores. With the vast majority of children’s time spent in school, alternative strategies to re-introduce physical activity back into schools are necessary. A creative yet underutilized solution to engage children in physical activity may be in before-school programs. The objective of the proposed study is to examine the effect of an unstructured, moderate to vigorous, before-school physical activity program on academic performance, classroom behavior, emotions, and other health related measures. Methods/Design Children in 3rd–5th grade will participate in a before-school (7:30–8:15 a.m.), physical activity program for 12 weeks, 3 days a week. Children will be able to choose their preferred activity and asked to sustain physical activity of moderate to vigorous intensity with individual heart rate monitored during each session. Discussion The proposed study explores an innovative method of engaging and increasing physical activity in children. The results of this study will provide evidence to support the feasibility of an unstructured, moderate to vigorous, before-school physical activity program in children and provide insight regarding the ideal physical activity intensity and duration necessary to achieve a positive increase in academic performance. Trial registration ClinicalTrials.gov Identifier: NCT01505244

Two recent examinations reported a strong association between blood pressure (BP) and resting energy expenditure (REE), independent of body mass and body composition. Both reports postulate that neurohumoral processes that contribute to variation in REE may partly mediate the body mass effect on BP. Therefore, we examined the relationship of REE and BP in 108 asymptomatic women (a) to confirm previous findings in a novel population and (b) to examine the impact of a marker of sympathetic tone on this relationship, as this was indicated as a potentially salient intermediary in previous reports. All testing was performed during a 4-day admission to the General Clinical Research Center. Resting energy expenditure was measured by indirect calorimetry, body composition was determined by dual-energy x-ray absorptiometry, and 24-hour fractionated urinary norepinephrine was determined by high-performance liquid chromatography. Multiple linear regression revealed REE as a significant predictor of systolic BP (β = 0.30, P = .04), independent of race (β = 0. 28, P = .01), age (β = −0.02, P = .80), height (β = −0.38, P = .08), fat mass (β = 0.22, P = .20), fat-free mass (β = 0.08, P = .65), and 24-hour fractionated urinary norepinephrine (β = 0.06, P = .57); and the same model using diastolic BP as the dependent variable approached significance (β = 0.24, P = .09). This study affirms previous findings that REE may be a potential mediator in resting BP, independent of many well-cited factors and, additionally, a marker of sympathetic tone.

Childhood obesity is a significant, worldwide, public health problem. Coinciding with the increasing prevalence of obesity in youth, Type 2 diabetes has emerged as a critical health condition in this population. In the U.S. alone, approximately 215,000 U.S. youth under the age of 20 were diagnosed with diabetes, with the majority of 10-19 years old diagnosed with Type 2 diabetes. Additionally, the exact number of youth that may have Type 2 diabetes yet remain undiagnosed is unknown. Increasing physical activity to encourage weight loss among youth may reduce the incidence of Type 2 diabetes in youth; however, several recent studies reported positive associations between physical activity and components of Type 2 diabetes without weight loss in youth. These findings support previous studies in adults which observed physical activity-induced improvements in insulin dynamics without changes in body fat. The purpose of this review was to identify studies which examined the effect of physical activity without dietary intervention on markers of insulin resistance in overweight and obese youth. These studies provide strong evidence that physical activity alone, without dietary intervention, can have a positive, significant impact on insulin resistance risk and potentially prevent the development of type 2 diabetes in overweight and obese youth. The studies reviewed provide support for future interventions to shift the focus from reducing obesity to increasing physical activity for the prevention of type 2 diabetes in obese youth.

Purpose:The aim of this investigation was to compare gender differences in physiologic and perceptual responses during a 1-h run at recent marathon pace and running economy at three speeds in recreational marathon runners.Methods:In a counterbalanced design, 10 men and 10 women completed a 1-h treadmill run and a running economy test. Treadmill speed for the 1-h run ranged from 141 to 241 m·min−1 and 134, 168, and 188 m·min−1 for running economy. Physiologic parameters (oxygen uptake, carbon dioxide production, pulmonary ventilation, and heart rate) and perceived exertion were measured. Repeated-measures ANOVA was used to compare any gender differences (P < .05) during the 1-h run and a two-way ANOVA was used to compare running economy. With this sample, estimated marathon energy expenditure, body composition, and maximal physiologic function was reported.1Results:With the exception of an allometric expression of VO2 (mL·min−1·kg BW−0.75), similar gender physiologic and perceptual responses were found during the 1-h run. Although not significant, the females exercised at a higher percent VO2max (8% to 9%) during the run. Similar gender differences were also noted during the running economy tests.Conclusions:Although the male runners completed a recent marathon significantly faster than the females, similar gender physiologic and perceptual responses were generally found during the 1-h treadmill run and the running economy tests.