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Background Low income and low health literacy are associated with poorer health knowledge, health behaviors and poor health outcomes. The effectiveness of health literacy-directed weight loss treatment interventions in primary care clinics is lacking. Objective The aim of this study was to conduct a pragmatic cluster-randomized trial (PROmoting Successful Weight Loss in Primary CarE in Louisiana ([PROPEL]) to test the effectiveness of a 24-month, patient-centered, literacy-directed obesity treatment program delivered within primary care in an underserved population. This study reports the association between health literacy and program effectiveness, examining potential correlates of weight loss related to patient adherence to the program. Methods We randomly assigned 18 clinics to usual care (UC) or a health literacy-directed lifestyle intervention (HLI). The primary outcome was percent weight loss at 24 months. Key Results Of 803 adult participants (84% women; 67% Black), 31% had limited health literacy. Patients in UC lost an average of 0.44%of their enrollment weight after 24 months. Those with adequate literacy lost 0.57% and those with limited literacy lost 0.30%, which was not significantly different. The HLI patient group lost an average of 4.9% of their enrollment weight. Those with adequate literacy lost 5.2% and those with limited literacy, 4.7%, which was not significantly different. The advantage of adequate health literacy was consistent across the 24-month study period, though not significant. Patients in the HLI group with adequate health literacy had greater percent weight loss by a margin of 0.50 ± 0.75 (p = .50), while the UC margin was 0.27 ± 0.84 (p = .74). The percent weight loss difference between HLI and UC groups was 4.6 ± 0.8 (p < .001) among patients with adequate health literacy and 4.4 ± 1.0 (p < .001) among patients with limited health literacy. The difference in percent weight loss between the HLI and UC groups was 0.2 ± 1.1 (p = .84) higher for adequate literacy patients. Conclusions A health literacy directed health coaching intervention in community clinics led to significant weight loss over 24 months but did not vary by level of patient health literacy. [HLRP: Health Literacy Research and Practice. 2024;8(4):e204–e211.]

Abstract Rationale Short‐term weight loss is possible in a variety of settings. However, long‐term, free‐living weight loss maintenance following structured weight loss interventions remains elusive. Objective The purpose was to study body weight trajectories over 2 years of intensive lifestyle intervention (ILI) and up to 4 years of follow‐up versus usual care (UC). Methods Data were obtained from electronic medical records (EMRs) from participating clinics. Baseline (Day 0) was established as the EMR data point closest but prior to the baseline date of the trial. The sample included 111 ILI and 196 UC patients. The primary statistical analysis focused on differentiating weight loss trajectories between ILI and UC. Results The ILI group experienced significantly greater weight loss compared with the UC group from Day 100 to Day 700, beyond which there were no significant differences. Intensive lifestyle intervention patients who maintained ≥5% and ≥10% weight loss at 24 months demonstrated significantly greater weight loss (p

Abstract Background Currently there are limited data as to whether dietary intake can be improved during pragmatic weight loss interventions in primary care in underserved individuals. Methods Patients with obesity were recruited into the PROPEL trial, which randomized 18 clinics to either an intensive lifestyle intervention (ILI) or usual care (UC). At baseline and months 6, 12, and 24, fruit and vegetable (F/V) intake and fat intake was determined. Outcomes were analyzed by repeated-measures linear mixed-effects multilevel models and regression models, which included random cluster (clinic) effects. Secondary analyses examined the effects of race, sex, age, and food security status. Results A total of 803 patients were recruited. 84.4% were female, 67.2% African American, 26.1% received Medicaid, and 65.5% made less than $40,000. No differences in F/V intake were seen between the ILI and UC groups at months 6, 12, or 24. The ILI group reduced percent fat at months 6, 12, and 24 compared to UC. Change in F/V intake was negatively correlated with weight change at month 6 whereas change in fat intake was positively associated with weight change at months 6, 12, and 24 for the ILI group. Conclusions The pragmatic weight loss intervention in primary care did not increase F/V intake but did reduce fat intake in an underserved population with obesity. F/V intake was negatively associated with weight loss at month 6 whereas percent fat was positively correlated with weight loss throughout the intervention. Future efforts better targeting both increasing F/V intake and reducing fat intake may promote greater weight loss in similar populations. Trial registration NCT Registration: NCT02561221

Abstract Objectives: to estimate the prevalence of leisure-time physical activity and sedentary behavior in adults in Brazil. Methods: this was a cross-sectional, population-based study carried out in a sample of 88,531 Brazilians, using data from the 2019 National Health Survey; leisure-time physical activity (overall and aerobic exercise) was measured according to the World Health Organization guidelines; the weighted prevalence and respective 95% confidence intervals (95%CI) of physical activity, physical inactivity and sedentary behavior were estimated. Results: according to the selected sample, 26.4% (95%CI 25.9;27.1) of Brazilian adults were physically active, 14.0% (95%CI 13.5;14.4) were insufficiently physically active and 59.5% (95%CI 58.8;60.2) were physically inactive; sedentary behavior ≥ 6 hours was reported by 30.1% (95%CI 29.5;30.8) of the population; only 8.6% (95%CI 8.2;8.9) met the recommendations for muscle-strengthening activities. Conclusion: most Brazilian adults were physically inactive and did not meet international recommendations for leisure-time physical activity and reduction in sedentary behavior.

Abstract Background In 2018, the Australian Government updated the Australian Physical Activity and Sedentary Behaviour Guidelines for Children and Young People. A requirement of this update was the incorporation of a 24-hour approach to movement, recognising the importance of adequate sleep. The purpose of this paper was to describe how the updated Australian 24-Hour Movement Guidelines for Children and Young People (5 to 17 years): an integration of physical activity, sedentary behaviour and sleep were developed and the outcomes from this process. Methods The GRADE-ADOLOPMENT approach was used to develop the guidelines. A Leadership Group was formed, who identified existing credible guidelines. The Canadian 24-Hour Movement Guidelines for Children and Youth best met the criteria established by the Leadership Group. These guidelines were evaluated based on the evidence in the GRADE tables, summaries of findings tables and recommendations from the Canadian Guidelines. We conducted updates to each of the Canadian systematic reviews. A Guideline Development Group reviewed, separately and in combination, the evidence for each behaviour. A choice was then made to adopt or adapt the Canadian recommendations for each behaviour or create de novo recommendations. We then conducted an online survey (n=237) along with three focus groups (n=11 in total) and 13 key informant interviews. Stakeholders used these to provide feedback on the draft guidelines. Results Based on the evidence from the Canadian systematic reviews and the updated systematic reviews in Australia, the Guideline Development Group agreed to adopt the Canadian recommendations and, apart from some minor changes to the wording of good practice statements, maintain the wording of the guidelines, preamble, and title of the Canadian Guidelines. The Australian Guidelines provide evidence-informed recommendations for a healthy day (24-hours), integrating physical activity, sedentary behaviour (including limits to screen time), and sleep for children (5-12 years) and young people (13-17 years). Conclusions To our knowledge, this is only the second time the GRADE-ADOLOPMENT approach has been used to develop movement behaviour guidelines. The judgments of the Australian Guideline Development Group did not differ sufficiently to change the directions and strength of the recommendations and as such, the Canadian Guidelines were adopted with only very minor alterations. This allowed the Australian Guidelines to be developed in a shorter time frame and at a lower cost. We recommend the GRADE-ADOLOPMENT approach, especially if a credible set of guidelines that was developed using the GRADE approach is available with all supporting materials. Other countries may consider this approach when developing and/or revising national movement guidelines.

Abstract This study investigated the associations between biological and environmental factors and gross-motor coordination (GMC) in Peruvian children and adolescents. The sample comprised 7401 boys and girls, aged 6–14 years, recruited from three geographical regions: sea-level, Amazon and high-altitude. Biological variables included age, sex, height, BMI, physical fitness, stunting, and maturational status. Environmental influences included geographical region and school characteristics. Gross-motor coordination was tested with the Körperkoordinationstest für Kinder and the data analyzed by multilevel logistic regression. Results showed a high prevalence of below normal GMC scores. Sex, age, geographical area, biological maturation, BMI (normal versus overweight/obesity), and stunting were all significant predictors of GMC. There was also an interaction between age, sex, and geographical area indicating that older girls who lived at sea-level and high-altitude were more likely to display below normal GMC scores. The school context was less important in predicting GMC problems than the interplay between biological characteristics and geographical region. These results suggest that early identification, as well as educational and pediatric care interventions, are of importance in reducing below normal GMC among Peruvian children and adolescents.

Abstract Background The home environment is an important facilitator of young child movement behaviors, including physical activity (PA), sleep, and screen-time. Household chaos, characterized by crowding, noise, and disorder in the home, may hinder efforts to obtain adequate amounts of movement behaviors. The COVID-19 outbreak impacted many families, and social distancing during this time may create conditions for more household chaos. Family routines can help establish order in the home and encourage an appropriate balance of movement behaviors, such as less screen-time and more sleep. The purpose of this study was to evaluate the association between household chaos and young child movement behaviors during the COVID-19 outbreak in the United States, and the role of family routines in this relationship. Methods A national online survey including 1836 mothers of preschoolers (3.0–5.9 years) was conducted during May 2020. Mothers reported demographic characteristics, household chaos, family routines, and the preschooler’s movement behaviors during the outbreak. Mothers completed a household chaos questionnaire and were grouped into chaos categories (low, moderate/low, moderate/high, and high) for analysis. Linear regression was used to assess the association between chaos category, family routines, and movement behaviors with adjustment for covariates. Results Mothers were 35.9 ± 4.1 years of age, middle income (47.8%), and preschoolers were 3.8 ± 0.8 years of age. Most mothers reported their preschooler was less physically active (38.9%), slept the same amount of time (52.1%), and increased their screen-time (74.0%) after the COVID-19 outbreak. Preschoolers in the high chaos households performed less total PA (β = − 0.36 days/week, 95% CI:-0.62 to − 0.09, p = 0.008), slept less (β = − 0.42 h, 95% CI:-0.59 to − 0.25, p = 0.001) and had more screen-time (β = 0.69 h, 95% CI:0.45 to 0.92, p = 0.001) compared to those in low chaos households. In most chaos categories, having a bed-time ritual was related to more child sleep, and mothers who viewed routines as “less/not important” reported more preschooler screen-time compared to mothers who viewed routines as “very important”. Conclusion Promoting bed-time rituals and prioritizing routines, even somewhat, may be related to an improved balance of child movement behaviors. Innovative measures are needed to support families during periods of disruption such as that experienced in the COVID-19 pandemic.

Abstract Background Few adolescents achieve sufficient levels of physical activity, and many are spending most of their time in sedentary behavior. Affective response following sedentary time may influence motivation to remain sedentary. Ecological Momentary Assessment (EMA) is a real-time data capture methodology that can be used to identify factors influencing sedentary time, such as the context of the home setting, and resulting affective state within a free-living setting. The purpose of this study was to evaluate the relationship between context at home and adolescent sedentary time, and the relationship of sedentary time and subsequent affect. Methods Adolescents (n = 284; 10–16 y) participated in an EMA study that used random, interval-based sampling methods. Adolescents each received 22 unannounced surveys over 7-days through a smartphone application. One survey was randomly sent within each 2-h time-period. These time-periods occurred between 4:00 pm-8:00 pm on weekdays and 8:00 am-8:00 pm on the weekend. This 15-question survey included a series of questions on context (indoors/outdoors, alone/not alone) and positive affect. Adolescents concurrently wore an accelerometer at the hip, and the 30-min bout of accelerometry data prior to each survey was used in analyses. Mixed-effect location scale models were used to examine the association between context at home and sedentary time (stage 1) and the adjusted sedentary time and positive affect (stage 2), with each model adjusted for covariates. Results Adolescents were 12.6 ± 1.9 y of age on average, about half were White (58%), and engaged in high levels of sedentary behavior during the 30 min prior to the survey (21.4 ± 6.8 min). Most surveys occurred when adolescents were with others (59%) and indoors (88%). In Stage 1, both being alone and being indoors at home were positively associated with sedentary time (p

By using paired molecular and antibody testing for severe acute respiratory syndrome coronavirus 2 infection, we determined point prevalence and seroprevalence in Louisiana, USA, during the second phase of reopening. Infections were highly variable by race and ethnicity, work environment, and ZIP code. Census-weighted seroprevalence was 3.6%, and point prevalence was 3.0%.

Background Data relating physical performance to the timing of the adolescent growth spurt are limited. Aim: This study identifies: (i) age-at-peak height velocity (APHV), (ii) physical performance spurt patterns aligned to APHV; and (iii) cross-cultural and time patterns in Canadian, Brazilian and Portuguese boys. Subjects and methods: A total of 512 boys (131 Canadian, 250 Portuguese and 131 Brazilian), 8–17 years of age were followed serially using longitudinal data. APHV was identified and five physical performance measures velocities [trunk extension (TE), trunk flexion (TF), standing long jump (SLJ), curl-ups (CU) and handgrip strength (HG)] were aligned at 6-month intervals, 4 years around the attainment of PHV. Velocities were estimated using a non-smooth mathematical procedure. Results: APHV was 13.9 ± 1.0, 13.4 ± 1.6 and 13.0 ± 0.8 years for Canadian, Brazilian and Portuguese boys, respectively. Maximal velocity in SLJ was attained between 12 and 6 months prior to PHV. For HG, peaks were attained 12–24 months after PHV. Maximal velocity in TE occurred between 12 and 0 months prior to PHV, while CU peaked between PHV and 6 months after PHV. Conclusion: Patterns of spurts in physical performance have remained relatively the same and do not appear to be influenced by cross-cultural differences.

Background Gross motor coordination (GMC) is a potential correlate of lifestyle behaviours and health outcomes in childhood and adolescence. Aims The aim of this study was to examine how sex, age, biological maturation, overweight, stunting, and physical fitness are associated with GMC in children and adolescents from Peru, and to examine associations between geographical area of residence, school-level characteristics, and GMC. Subjects and methods The sample included 7408 subjects, aged 6–14 years, from sea level, Amazon and high-altitude regions of Peru. A composite marker of total coordination was derived by the sum of scores from each test (GMCT). Overweight was identified using BMI, and biological maturation, physical fitness, and stunting were assessed. School characteristics were obtained via an objective audit. Results Boys (β = 12.23 ± 0.90) and older children (β = 13.37 ± 0.64) had higher GMCT than girls and younger children, respectively. Overweight was associated with lower GMCT (β = −5.23 ± 0.80), whereas fitness was positively associated with GMCT (β = 6.30 ± 0.25). Biological maturation was not a predictor; however, stunting was negatively associated with GMCT (β = −3.71 ± 1.56). Subjects living in the Amazon had higher GMCT than those at sea level (β = 16.57 ± 4.73). Five of nine school-level predictors (number of students, playground area with obstacles, multi-sports roofed, frequency and duration of Physical Education classes) were significant predictors of GMCT. Conclusions Child- and school-level variables were significantly associated with GMCT in this sample. These findings are important for the Peruvian community, especially school principals, councils and physical education teachers, helping them to define more efficient strategies and action plans to increase motor coordination in children.

Objective: Children's differences in moderate‐to‐vigorous physical activity levels are not at random. This study investigates the relevance of individual‐ and school‐level characteristics in explaining these differences. Methods: In total, 307 children (154 girls) aged 5–10 years, from 19 Portuguese schools, were sampled. Height and weight were measured, and body mass index was calculated. Time spent in moderate‐to‐vigorous physical activity was measured by accelerometry. Gross motor coordination was assessed with the KörperkoordinationsTest für Kinder battery and socio‐economic status was obtained via the school social support system. School characteristics were obtained with an objective school audit. A multilevel analysis was used as implemented in Stata 15. Results: Schools explained 18.2% of the total variance in moderate‐to‐vigorous physical activity, with the remainder being ascribed to children's distinct characteristics. Boys were more active (β = 29.59 ± 11.52, p

Objectives: Excessive recreational screen time (RST) is associated with detrimental effects for physical, psychological and cognitive development. This article aims to describe the prevalence of excessive RST among Colombian preschoolers, children and adolescents and explore its factors associated.Methods: We analyzed data from the National Survey of Nutrition 2015. The sample included 4,503 preschoolers, 5,333 school-aged children and 6,623 adolescents. Poisson regression models with robust variance were conducted to estimate prevalence ratios and determine associated factors of excessive RST.Results: Fifty percent of preschoolers, 61% of school-aged children and 73% of adolescents in Colombia had excessive RST. Positive associations were observed with the availability of TV in the child’s bedroom, the availability of video games at home, and eating while using screens. A negative association with rural area was observed for all age groups.Conclusion: The majority of Colombian children and adolescents have excessive RST. Younger preschoolers, older school-aged children, wealthiest children and those from urban areas should be targeted by interventions to decrease RST. These interventions should promote limiting the availability of electronic devices in children’s bedrooms and not eating in front of screens.

As part of the National Children's Study (NCS) comprehensive and longitudinal assessment of the health status of the whole child, scientific teams were convened to recommend assessment measures for the NCS. This manuscript documents the work of three scientific teams who focused on the motor, sensory, or the physical health aspects of this assessment. Each domain team offered a value proposition for the importance of their domain to the health outcomes of the developing infant and child. Constructs within each domain were identified and measures of these constructs proposed. Where available extant assessments were identified. Those constructs that were in need of revised or new assessment instruments were identified and described. Recommendations also were made for the age when the assessments should take place.

Abstract Background Insufficient physical activity, short sleep duration, and excessive recreational screen time are increasing globally. Currently, there are little to no data describing prevalences and correlates of movement behaviours among children in low-middle-income countries. The few available reports do not include both urban and rural respondents, despite the large proportion of rural populations in low-middle-income countries. We compared the prevalence of meeting 24-h movement guidelines and examined correlates of meeting the guidelines in a sample of urban and rural Mozambican schoolchildren. Methods This is cross-sectional study of 9–11 year-old children (n = 683) recruited from 10 urban and 7 rural schools in Mozambique. Moderate- to vigorous-intensity physical activity (MVPA) and sleep duration were measured by waist-worn Actigraph GT3X+ accelerometers. Accelerometers were worn 24 h/day for up to 8 days. Recreational screen time was self-reported. Potential correlates of meeting 24-h movement guidelines were directly measured or obtained from validated items of context-adapted questionnaires. Multilevel multivariable logit models were used to determine the correlates of movement behaviours. Meeting 24-h movement guidelines was defined as ≥60 min/day of MVPA, ≤2 h/day of recreational screen time, and between 9 and 11 h/night of sleep. Results More rural (17.7%) than urban (3.6%) children met all three 24-h movement guidelines. Mean MVPA was lower (82.9 ± 29.5 min/day) among urban than rural children (96.7 ± 31.8 min/day). Rural children had longer sleep duration (8.9 ± 0.7 h/night) and shorter recreational screen time (2.7 ± 1.9 h/day) than their urban counterparts (8.7 ± 0.9 h/night and 5.0 ± 2.3 h/day respectively). Parental education (OR: 0.37; CI: 0.16–0.87), school location (OR: 0.21; CI: 0.09–0.52), and outdoor time (OR: 0.67; CI: 0.53–0.85) were significant correlates of meeting all three 24-h movement guidelines. Conclusions Prevalence and correlates of meeting movement guidelines differed between urban and rural schoolchildren in Mozambique. On average, both groups had higher daily MVPA minutes, shorter sleep duration, and higher recreational screen time than the 24-h movement guidelines recommend. These findings (e.g., higher than recommended mean daily MVPA minutes) differ from those from high-income countries and highlight the need to sample from both urban and rural areas.

Abstract Background Existing research has documented inconsistent findings for the associations among breakfast frequency, physical activity (PA), and sedentary time in children. The primary aim of this study was to examine the associations among breakfast frequency and objectively-measured PA and sedentary time in a sample of children from 12 countries representing a wide range of human development, economic development and inequality. The secondary aim was to examine interactions of these associations between study sites. Methods This multinational, cross-sectional study included 6228 children aged 9–11 years from the 12 International Study of Childhood Obesity, Lifestyle and the Environment sites. Multilevel statistical models were used to examine associations between self-reported habitual breakfast frequency defined using three categories (breakfast consumed 0 to 2 days/week [rare], 3 to 5 days/week [occasional] or 6 to 7 days/week [frequent]) or two categories (breakfast consumed less than daily or daily) and accelerometry-derived PA and sedentary time during the morning (wake time to 1200 h) and afternoon (1200 h to bed time) with study site included as an interaction term. Model covariates included age, sex, highest parental education, body mass index z-score, and accelerometer waking wear time. Results Participants averaged 60 (s.d. 25) min/day in moderate-to-vigorous PA (MVPA), 315 (s.d. 53) min/day in light PA and 513 (s.d. 69) min/day sedentary. Controlling for covariates, breakfast frequency was not significantly associated with total daily or afternoon PA and sedentary time. For the morning, frequent breakfast consumption was associated with a higher proportion of time in MVPA (0.3%), higher proportion of time in light PA (1.0%) and lower min/day and proportion of time sedentary (3.4 min/day and 1.3%) than rare breakfast consumption (all p ≤ 0.05). No significant associations were found when comparing occasional with rare or frequent breakfast consumption, or daily with less than daily breakfast consumption. Very few significant interactions with study site were found. Conclusions In this multinational sample of children, frequent breakfast consumption was associated with higher MVPA and light PA time and lower sedentary time in the morning when compared with rare breakfast consumption, although the small magnitude of the associations may lack clinical relevance. Trial registration The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) is registered at (Identifier NCT01722500).

Objective: To identify factors associated with total sedentary time and screen time in children aged 9–11 years. Methods: For seven consecutive days, 328 children (51.5% boys) used accelerometers to monitor total sedentary time. Screen time was calculated by the self-reporting method. Individual, family, family environment, and school environment questionnaires were filled out. Body composition was measured using a Tanita scale. Results: The mean sedentary time was 500 min/day (boys: 489, girls: 511, p = 0.005), and mean screen time was 234 min/day (boys: 246, girls: 222, p = 0.053). In both genders, factors associated with sedentary time were healthy dietary pattern and moderate-to-vigorous physical activity. In boys, only moderate-to-vigorous physical activity was significant; in girls, the healthy dietary pattern, moderate-to-vigorous physical activity, and transportation to school were significant. As for the screen time, the associated factors were body mass index and healthy dietary pattern (both genders). In boys, the associated factors were body mass index, healthy dietary pattern, and television in the bedroom. In girls, the associated factors were healthy dietary pattern, transportation to school, and physical activity policies or practice at school. Conclusion: Several associated factors were identified in the association between total sedentary time and screen time in children; however, only the healthy dietary pattern was common between sedentary time and screen time. Resumo: Objetivo: Identificar os fatores associados do tempo sedentário total e tempo de tela em crianças entre 9-11 anos. Métodos: Durante sete dias consecutivos, 328 crianças (51,5% meninos) usaram acelerômetros para monitorar o tempo sedentário total. O tempo de tela foi calculado pelo método autorreferido. Questionários com fatores individuais, familiares, ambiente familiar e escolar foram preenchidos. A composição corporal foi medida usando uma balança Tanita. Resultados: A média do tempo sedentário (min/dia) foi de 500 (meninos: 489; meninas: 511; p = 0,005), e do tempo de tela foi 234 (meninos: 246; meninas: 222; p = 0,053). Em ambos os sexos, os fatores associados do tempo sedentário foram o padrão de dieta saudável e atividade física de moderada a vigorosa. Nos meninos, apenas a atividade física de moderada a vigorosa foi significativa e nas meninas o padrão de dieta saudável, atividade física de moderada a vigorosa e transporte para a escola foi significativo. Já para o tempo de tela, os fatores associados foram o índice de massa corporal e padrão de dieta saudável (ambos os sexos). Nos meninos, os fatores associados foram o índice de massa corporal, o padrão de dieta saudável e televisão no quarto. Nas meninas, os fatores associados foram o padrão de dieta saudável, transporte para escola e políticas ou práticas de atividade física na escola. Conclusão: Vários fatores associados foram identificados entre tempo sedentário total e tempo de tela em crianças. Entretanto, somente o padrão de dieta saudável foi comum entre tempo sedentário e tempo de tela. Keywords: Sedentary lifestyle, Accelerometry, Health, Obesity, Children, Palavras-chave: Estilo de vida sedentário, Acelerometria, Saúde, Obesidade, Crianças

Background: The development of gross motor coordination (GMC) is governed by biological and environmental factors whose effect sizes are still unclear. Aim: To investigate sibling resemblance in GMC, as well as biological and environmental correlates of GMC among Peruvian children. Materials and methods: The sample comprised 1256 biological siblings (6–15 years old), from three geographical areas of Peru. GMC was assessed using the Korperkoordinationtest für Kinder (KTK) test battery. Anthropometry, biological maturation and physical fitness (PF) were also measured. Multilevel modelling was performed using Stata 14 software. Results: In general, sister–sister pairs (SS) showed the highest resemblance in GMC (ρ = 0.24) compared to brother–sister (BS) (ρ = 0.10) and brother–brother (BB) pairs (ρ = 0.07). On average, BB pairs had higher GMC than SS pairs and older siblings had higher GMC than younger siblings. Further, those with lower body mass index (BMI) and higher PF had higher GMC. There was also a significant interaction between age and PF with GMC. Siblings from the rainforest region demonstrated higher GMC than those from sea level and high-altitude siblings demonstrated lower GMC than their sea-level peers. Conclusion: These results demonstrate statistically significant sibling resemblance in GMC. Age, BMI, PF and geographical area were significant correlates of GMC.

Background: Children’s physical fitness is potentially influenced by biological, behavioural and environmental factors. Aim: To investigate the importance of individual-level and school-level characteristics in explaining variation in children’s physical fitness. Subjects and methods: The sample comprised 354 Portuguese children, aged 5–10 years. Physical fitness [(handgrip (HG) strength, standing long jump (SLJ), shuttle-run (SR), total physical fitness score (PFz)], gross motor coordination (GMC) and body mass index (BMI) were assessed. Moderate-to-vigorous physical activity (MVPA) was objectively monitored; birth weight and socio-economic status (SES) were obtained by questionnaire. School contexts were assessed via an objective audit. Multilevel models using the Bayesian approach were used. Results: Age was positively associated with HG, SLJ and PFz (p

Background: Obesity, particularly in Native Hawaiians, is an important health risk. A possible contributing factor to obesity is reduced physical activity levels. Aim: This study investigates the relationship between measured levels of physical activity and body composition in two grade cohorts of school children of Native Hawaiian/Pacific Islander (NHPI) and non-NHPI ethnicity. Methods: A sample of 105 Kindergarteners and third graders were measured for adiposity, physical fitness, and physical activity levels. Ethnicity was determined from genealogical surveys. BMI, waist circumference (WC) and body fat percentage derived from air displacement plethysmography were used to evaluate adiposity. Maximal oxygen consumption (VO2max/kg) was estimated and total energy expenditure (TEE), physical activity level (PAL) and percentage of time inactive (PTI) were determined using the Flex-heart rate method. Results: VO2max, but not TEE, PAL or PTI, was significantly correlated with BMI in Kindergarteners; while VO2max and PAL were negatively correlated with BMI, PAL was significantly negatively correlated with WC and PTI was positively correlated with fat percentage among third graders. There were no significant ethnic differences in VO2max, TEE, PAL or PTI. Conclusions: PAL and PTI are moderately related to adiposity measures, and there are no ethnic differences in physical activity or fitness measures in this sample.

Abstract Background Time spent outdoors is associated with higher physical activity levels among children, yet it may be threatened by parental safety concerns and the attraction of indoor sedentary pursuits. The purpose of this study was to explore the relationships between these factors and outdoor time during children’s discretionary periods (i.e., after school and over the weekend). Methods Data from 462 children aged 9–11 years old were analysed using generalised linear mixed models. The odds of spending > 1 h outdoors after school, and > 2 h outdoors on a weekend were computed, according to demographic variables, screen-based behaviours, media access, and parental safety concerns. Interactions with sex and socioeconomic status (SES) were explored. Results Boys, low SES participants, and children who played on their computer for 1 h outside after school than girls, high SES children and those playing on a computer for ≥2 h, respectively. Counterintuitive results were found for access to media devices and crime-related safety concerns as both of these were positively associated with time spent outdoors after school. A significant interaction for traffic-related concerns*sex was found; higher road safety concerns were associated with lower odds of outdoor time after school in boys only. Age was associated with weekend outdoor time, which interacted with sex and SES; older children were more likely to spend > 2 h outside on weekends but this was only significant among girls and high SES participants. Conclusions Our results suggest that specific groups of children are less likely to spend their free time outside, and it would seem that only prolonged recreational computer use has a negative association with children’s outdoor time after school. Further research is needed to explore potential underlying mechanisms, and parental safety concerns in more detail.

Abstract Background Daily activity data are by nature compositional data. Accordingly, they occupy a specific geometry with unique properties that is different to standard Euclidean geometry. This study aimed to estimate the difference in adiposity associated with isotemporal reallocation between daily activity behaviours, and to compare the findings from compositional isotemporal subsitution to those obtained from traditional isotemporal substitution. Methods We estimated the differences in adiposity (body fat%) associated with reallocating fixed durations of time (isotemporal substitution) between accelerometer-measured daily activity behaviours (sleep, sedentary time and light and moderate-to-vigorous physical activity (MVPA)) among 1728 children aged 9–11 years from Australia, Canada, Finland and the UK (International Study of Childhood Obesity, Lifestyle and the Environment, 2011–2013). We generated estimates from compositional isotemporal substitution models and traditional non-compositional isotemporal substitution models. Results Both compositional and traditional models estimated a positive (unfavourable) difference in body fat% when time was reallocated from MVPA to any other behaviour. Unlike traditional models, compositional models found the differences in estimated adiposity (1) were not necessarily symmetrical when an activity was being displaced, or displacing another (2) were not linearly related to the durations of time reallocated, and (3) varied depending on the starting composition. Conclusion The compositional isotemporal model caters for the constrained and therefore relative nature of activity behaviour data and enables all daily behaviours to be included in a single statistical model. The traditional model treats data as real variables, thus the constrained nature of time is not accounted for, nor reflected in the findings. Findings from compositional isotemporal substitution support the importance of MVPA to children’s health, and suggest that while interventions to increase MVPA may be of benefit, attention should be directed towards strategies to avoid decline in MVPA levels, particularly among already inactive children. Future applications of the compositional model can extend from pair-wise reallocations to other configurations of time-reallocation, for example, increasing MVPA at the expense of multiple other behaviours.

Objective: This study aimed to identify the prevalence and factors associated with body mass index (BMI) in children aged 9–11 years. Methods: The study is part of the International Study of Childhood Obesity Lifestyle and the Environment (Iscole). Body composition was determined using the bipolar bioimpedance technique. The mean BMI value was categorized as recommended by the World Health Organization. For seven consecutive days, participants used an accelerometer to objectively monitor sedentary behavior (SB) and moderate to vigorous physical activity. Individual factors (anthropometric and behavioral), family aspects, and family and school environment were provided by participants and parents and were analyzed by multilevel linear regression adjusted for gender, ethnicity, school, number of siblings, and total annual family income. Results: The mean BMI was 20.1 kg/m2, and 51.8% of the children were overweight/obese (50.3% boys, 53.4% girls, p = 0.014). Considering all participants, the associated factors of BMI were body fat percentage (BF%, β = 0.0216, p

Background: Somatotype is a complex trait influenced by different genetic and environmental factors as well as by other covariates whose effects are still unclear. Aims: To (1) estimate siblings’ resemblance in their general somatotype; (2) identify sib-pair (brother–brother (BB), sister–sister (SS), brother–sister (BS)) similarities in individual somatotype components; (3) examine the degree to which between and within variances differ among sib-ships; and (4) investigate the effects of physical activity (PA) and family socioeconomic status (SES) on these relationships. Subjects and methods: The sample comprises 1058 Portuguese siblings (538 females) aged 9–20 years. Somatotype was calculated using the Health-Carter method, while PA and SES information was obtained by questionnaire. Multi-level modelling was done in SuperMix software. Results: Older subjects showed the lowest values for endomorphy and mesomorphy, but the highest values for ectomorphy; and more physically active subjects showed the highest values for mesomorphy. In general, the familiality of somatotype was moderate (ρ = 0.35). Same-sex siblings had the strongest resemblance (endomorphy: ρSS > ρBB > ρBS; mesomorphy: ρBB = ρSS > ρBS; ectomorphy: ρBB > ρSS > ρBS). For the ectomorphy and mesomorphy components, BS pairs showed the highest between sib-ship variance, but the lowest within sib-ship variance; while for endomorphy BS showed the lowest between and within sib-ship variances. Conclusions: These results highlight the significant familial effects on somatotype and the complexity of the role of familial resemblance in explaining variance in somatotypes.

Abstract Background Although ‘unhealthy’ diet is a well-known risk factor for non-communicable diseases, its relationship with socio-economic status (SES) has not been fully investigated. Moreover, the available research has largely been conducted in countries at high levels of human development. This is the first study to examine relationships among dietary patterns and SES of children from countries spanning a wide range of human development. Methods This was a multinational cross-sectional study among 9–11 year-old children (n = 6808) from urban/peri-urban sites across 12 countries. Self-reported food frequency questionnaires were used to determine the children’s dietary patterns. Principal Components Analysis was employed to create two component scores representing ‘unhealthy’ and ‘healthy’ dietary patterns. Multilevel models accounting for clustering at the school and site level were used to examine the relationships among dietary patterns and SES. Results The mean age of participants in this study (53.7% girls) was 10.4 years. Largest proportions of total variance in dietary patterns occurred at the individual, site, and school levels (individual, school, site: 62.8%; 10.8%; 26.4% for unhealthy diet pattern (UDP) and 88.9%; 3.7%; 7.4%) for healthy diet pattern (HDP) respectively. There were significant negative ‘unhealthy’ diet-SES gradients in 7 countries and positive ‘healthy’ diet-SES gradients in 5. Within country diet-SES gradients did not significantly differ by HDI. Compared to participants in the highest SES groups, unhealthy diet pattern scores were significantly higher among those in the lowest within-country SES groups in 8 countries: odds ratios for Australia (2.69; 95% CI: 1.33–5.42), Canada (4.09; 95% CI: 2.02–8.27), Finland (2.82; 95% CI: 1.27–6.22), USA (4.31; 95% CI: 2.20–8.45), Portugal (2.09; 95% CI: 1.06–4.11), South Africa (2.77; 95% CI: 1.22–6.28), India (1.88; 95% CI: 1.12–3.15) and Kenya (3.35; 95% CI: 1.91–5.87). Conclusions This study provides evidence of diet-SES gradients across all levels of human development and that lower within-country SES is strongly related to unhealthy dietary patterns. Consistency in within-country diet-SES gradients suggest that interventions and public health strategies aimed at improving dietary patterns among children may be similarly employed globally. However, future studies should seek to replicate these findings in more representative samples extended to more rural representation.

Background: Given the low levels of physical activity (PA) among adolescent girls in the US, there is a need to identify tools to motivate increased PA. Although there is limited evidence that adolescents transfer PA from one context to another, exergames (i.e., video games that require gross motor activity) may act as a gateway to promote overall PA outside game play. The purpose of this study was to examine potential transfer effects (i.e., influences on external behaviors and psychological constructs) of a 12-week exergaming intervention on adolescent girls' PA, screen time, and self-efficacy toward PA, as well as the intrinsic motivation of exergaming. Methods: Participants were 37 girls aged 14–18 years (65% African American, 35% white) who were overweight or obese (body mass index ≥ 85th percentile) and were recruited from the community via school, physicians, news media, and social media websites. Adolescents were randomly assigned to a 12-week group exergaming intervention (thirty-six 60 min sessions of group-based dance exergaming in a research laboratory using Kinect for Xbox 360 (Microsoft Corporation, Redmond, WA, USA)) or to a no-treatment control group. Outcome variables included objectively measured PA (total) and self-reported leisure-time PA (discretionary time only) 1 week before vs. 1 week after the intervention; selected type and intensity of PA when placed in a gym setting for 30 min (“cardio free choice”); screen time; self-efficacy toward PA; and intrinsic motivation toward exergaming. Results: Attendance at the exergaming sessions was high (80%). Compared with the control group, the intervention group self-reported an increase in PA (p = 0.035) and fewer hours watching television or videos (p = 0.01) after the intervention, but there were no significant differences in sedentary, light, moderate, or vigorous PA measured by accelerometry. The intervention group significantly improved self-efficacy toward PA (p = 0.028). The intervention group highly rated intrinsic motivation toward exergaming. Conclusion: Exergaming for 12 weeks was associated with positive impacts on adolescent girls' self-reported PA, television viewing, self-efficacy, and intrinsic motivation. Future research is warranted to leverage exergames as an enjoyable, motivating, and effective PA tool.

Background/Objectives. Obesity markers evolve over time and these changes are shared within the family orbit and governed by individual and environmental characteristics. Available reports often lack an integrated approach, in contrast to a multilevel framework that considers their concurrent influence. Hence, this study aims to (1) describe mean changes in obesity markers (body fat (%BF), body mass index (BMI), and waist circumference (WC)) across sib-ships; (2) analyze tracking of individuals within their sib-ship in these markers during 2 years of follow-up; (3) probe consistency in sibling resemblance in these markers; and (4) analyze the joint influence of individual and familial characteristics in these markers. Subjects/Methods. The sample comprises 168 biological Portuguese siblings (brother-brother (BB), sister-sister (SS), and brother-sister (BS)) aged 9–17 years. %BF, BMI, and WC were measured using standardized protocols, and biological maturation was assessed. Physical activity, diet, screen time, and familial characteristics were obtained by questionnaires. Multilevel models were used to analyze the clustered longitudinal data. Sibling resemblance was estimated with the intraclass correlation. Results. On average, all sib types increased in BMI and WC over 2 years of follow-up, and SS pairs increased in %BF. Individuals within sib-ships track high in all obesity markers across time. Consistency in siblings’ resemblance was also noted, except for BB pairs in %BF which decreased at follow-up. More maturing siblings tend to have higher values in all markers. Greater screen time was associated with higher %BF, whereas those consuming more sugary drinks had lower %BF and BMI values. Siblings whose mothers had less qualified occupations tended to have lower BMI values. Conclusions. Longitudinal individual tracking and sibling resemblance for obesity markers were found. Yet, different trajectories were also identified depending on the marker and sib type. Individual and familial characteristics exert different influences on each obesity marker.

Background and Aim. Overweight prevalence in children and adolescents shows great variability which is related to individual-level and environmental-level factors. The present study aimed to determine the prevalence of and factors associated with overweight in Peruvian children and adolescents living at different altitudes. Methods. 8568 subjects, aged 6–16 y, from the sea level, Amazon, and high-altitude regions were sampled. Overweight was identified using BMI; biological maturation and physical fitness were measured; school characteristics were assessed via an objective audit. Results. Overweight prevalence decreased with age (28.3% at 6 y to 13.9% at 16 y); it was higher in girls (21.7%) than boys (19.8%) and was higher at the sea level (41.3%), compared with Amazon (18.8%) and high-altitude (6.3%) regions. Approximately 79% of the variance in overweight was explained by child-level characteristics. In Model 1, all child-level predictors were significant (p

Abstract Background The neighborhood environment has the potential to influence children’s participation in physical activity. However, children’s outdoor play is controlled by parents to a great extent. This study aimed to investigate whether parents' perceptions of the neighborhood environment and the objectively measured neighborhood environment were associated with children's moderate-to-vigorous intensity physical activity (MVPA) outside of school hours; and to determine if these perceptions and objective measures of the neighborhood environment differ between high and low socio-economic status (SES) groups. Methods In total, 258 parents of 9–11 year-old children, recruited from the South African sample of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE), completed a questionnaire concerning the family and neighborhood environment. Objective measures of the environment were also obtained using Geographic Information Systems (GIS). Children wore an Actigraph (GT3X+) accelerometer for 7 days to measure levels of MVPA. Multilevel regression models were used to determine the association between the neighborhood environment and MVPA out of school hours. Results Parents’ perceptions of the neighborhood physical activity facilities were positively associated with children’s MVPA before school (β = 1.50 ± 0.51, p = 0.003). Objective measures of neighborhood safety and traffic risk were associated with children’s after-school MVPA (β = −2.72 ± 1.35, p = 0.044 and β = −2.63 ± 1.26, p = 0.038, respectively). These associations were significant in the low SES group (β = −3.38 ± 1.65, p = 0.040 and β = −3.76 ± 1.61, p = 0.020, respectively), but unrelated to MVPA in the high SES group. Conclusions This study found that several of the objective measures of the neighborhood environment were significantly associated with children’s outside-of-school MVPA, while most of the parents’ perceptions of the neighborhood environment were unrelated.

Dance exergaming, which involves playing an interactive video game that requires the player to make upper and lower body movements by dancing to music, may provide a social physical activity experience that positively impacts psychosocial health. The objective of this randomized controlled study was to examine the effects of group-based dance exergaming on adolescent girls’ psychosocial health including enjoyment, subjective health, perceived peer support, and health-related quality of life. Forty-one adolescents with overweight/obesity were randomly assigned to a 12-week dance exergaming intervention or to a control group. Peer support, subjective health, and health-related quality of life (HRQOL) were assessed pre- and post-intervention, and intervention participants rated enjoyment after each exergaming session. Repeated measures analysis of covariance models controlling for age and baseline body mass index were used to examine condition differences. Results indicated that subjective health improved in the exergaming condition more than control (p = .02). Ratings of peer conflict after the intervention were significantly different by condition (p = .01), with peer conflict stabilizing in the exergaming group and worsening in the control group. There was no difference by condition for HRQOL. Enjoyment remained high throughout the intervention. In summary, group exergaming improved subjective health, stabilized peer conflict, and provided an enjoyable physical activity experience for overweight adolescent girls.

Abstract Aim: The purpose of this study was to analyse the effects of age, sex, body mass index (BMI) and country of origin (Mozambique versus Portugal) on physical activity and sedentariness. Methods: Sample size was comprised of 593 adolescents from Mozambique (n=258) and Portugal (n=335), aged 10-15 years old. Height and weight were measured, and BMI was computed; furthermore, subjects were classified in two groups (normal weight and overweight/obese). The mean time (min/day) spent in moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and sedentary activity were assessed using the GT3X Actigraph accelerometer over at least 4 days (1 weekend day) with a minimum of 10 hours/day of monitoring. Multiple regression analysis was done in SPSS 20. Results: A low percentage of Mozambican (3.9%) and Portuguese (4.3%) youth complied with the MVPA recommendations (60min·day-1). However, Portuguese boys spend more time in MVPA. Girls and those with higher BMI spend more time in sedentary activities and less time in MVPA and LPA; older adolescents spend more time in sedentary activities and less time in LPA. There is a significant effect of the country of origin on MVPA, favouring Portuguese youth. Conclusions: Results suggest country differences in MVPA between Mozambican and Portuguese youth - the Mozambicans are less involved in MVPA than the Portuguese, probably reinforcing the undesirable effect of the urbanization process in developing nations.

Abstract The prevention of weight gain to address the obesity epidemic rather than weight loss involves promoting small changes in food choices and physical activity. People United to Sustain Health (PUSH) was designed to increase fruit and vegetable consumption, physical activity, and food security to prevent weight gain in rural adults. Forty‐nine participants were randomized into a treatment group which received access to a “Rolling Store,” nutrition education and physical activity, and a control group which received family coping classes. Forty‐one (84%) of participants completed the study. At the end of 6 months, weight for all participants was maintained from baseline to completion with no significant differences between the groups. The mean fruit consumption over 6 months for the treatment group increased and was significantly greater than change in the control group (p = 0.01). This community‐based participatory research study was considered successful because weight gain was prevented.

Objective: Waist circumference (WC) is a useful anthropometric tool to estimate cardiometabolic risk. However, BMI influences the relationship between WC and health. This study determined BMI-, sex- and race-specific WC thresholds. Methods: The study sample included 6,452 whites and African Americans (AA) aged 18-64 years. WC, BMI, and cardiovascular risk factors were assessed in the clinic. An elevated cardiometabolic risk was defined as the presence of ≥2 cardiometabolic risk factors. Receiver Operating Characteristic (ROC) curves were used to determine BMI-, sex-, and race-specific WC thresholds. Results: Based on logistic regression, elevated WC within each BMI category was associated with higher cardiometabolic risk. The respective optimal BMI-specific WC thresholds for white women, AA women, white men, and AA men were as follows: 72, 76, 82, and 78 cm for normal-weight (18.5-24.9 kg/m2); 87, 85, 95, and 92 cm for overweight (25-29.9 kg/m2); 97, 97, 107, and 104 cm for obese I (30-34.9 kg/m2); and 111, 110, 120, and 119 cm for obese II+ (≥35 kg/m2) participants. Sensitivities ranged from 52.7 to 73.3%, and specificities ranged from 57.1 to 73.5%. Conclusion: The proposed optimal BMI-, sex-, and race-specific WC thresholds are warranted for use in the clinical setting until representative standards become available based on results from longitudinal studies.

In order to verify if the full moon is associated with sleep and activity behaviors, we used a 12-country study providing 33710 24-hour accelerometer recordings of sleep and activity. The present observational, cross-sectional study included 5812 children ages 9-11 years from study sites that represented all inhabited continents and wide ranges of human development (Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, United Kingdom and United States). Three moon phases were used in this analysis: full moon (±4 days; reference), half moon (±5-9 days) and new moon (±10-14 days) from nearest full moon. Nocturnal sleep duration, moderate-to-vigorous physical activity (MVPA), light-intensity physical activity (LPA) and total sedentary time (SED) were monitored over 7 consecutive days using a waist-worn accelerometer worn 24 hours a day. Only sleep duration was found to significantly differ between moon phases (~5 min per night shorter during full moon compared to new moon). Differences in MVPA, LPA and SED between moon phases were negligible and non-significant (

OBJECTIVES/SPECIFIC AIMS: The current pilot study will use a mixed methods approach to investigate the role of psychological mechanisms in the relationship between food insecurity and obesity. We will be the first to assess 4 key psychological constructs (delay discounting, grit, future time perspective, and subjective social status) in a sample of food secure and food insecure adults with and without obesity. The specific aims are: (1) Examine associations among psychological mechanisms, food security status, and body mass index (BMI); and (2) Collect qualitative data on psychological mechanisms linking food insecurity and BMI. METHODS/STUDY POPULATION: This is a cross-sectional, observational pilot study that will be conducted in the local Baton Rouge community. The target study sample is 56 food secure and food insecure women and men aged 18–49 years with a BMI of 20.0 kg/m2 or greater. Independent (grouping) variables are food security status and BMI. Primary endpoints are 4 psychological constructs measured via questionnaires: (1) delay discounting, (2) grit, (3) future time perspective, and (4) subjective social status. We will also assess a number of key covariates, including health literacy, sociodemographics, food assistance use, and dietary quality. Semistructured, in-depth interviews will be conducted in a subsample of 12 participants. RESULTS/ANTICIPATED RESULTS: For quantitative data, we will test for significant associations between food insecurity, obesity, and selected psychological mechanisms via bivariate correlations and linear and logistic regression models. Qualitative data will be analyzed to identify key themes and concepts that conceptually link the aforementioned psychological mechanisms to food insecurity and obesity. Analyzed qualitative data will be triangulated with quantitative findings. DISCUSSION/SIGNIFICANCE OF IMPACT: This pilot study will examine the role of psychological mechanisms in the relationship between food insecurity and obesity. Moreover, we are gathering data to identify potentially new intervention targets that will be used to develop intervention strategies aimed at reducing health disparities by effectively promoting weight management among low socioeconomic populations.

OBJECTIVES/SPECIFIC AIMS: The majority of obese adults do not become obese until adulthood. Although adults spend the equivalent of a 40-hour work week in front of the television (TV), there are mixed data on whether the sedentary behavior of TV viewing is linked with weight gain during adulthood. The purpose of this study was to examine the associations among sedentary behavior, measured as TV viewing and TV in the bedroom, with eating behavior, eating attitudes and cravings, fat gain, and blood pressure in healthy young adults over a 2-year period. METHODS/STUDY POPULATION: The sample included 73 healthy, nonobese adults (56% women, 80% white) who were 26.8±4.5 years of age with a body mass index of 22.9±2.4 kg/m2. Participants completed clinic visits at baseline and 2-years later (Year 2) which assessed weight, height, blood pressure, waist circumference, and total body fat measured by dual energy X-ray absorptiometry. A food frequency questionnaire was used to estimate dietary intake, and the eating inventory was used to assess dietary restraint, disinhibition, and hunger. At baseline, participants self-reported TV habits including number of hours/week of watching TV (including cable, VCR, DVD) and presence of a TV in the bedroom. For the analysis, participants were stratified by quartiles of TV viewing time. T tests were used to examine the association between TV viewing and bedroom TV. Linear regression models were used to examine the association between TV viewing and each anthropometric and body composition measure and change over the 2-year period, as well as with the dietary constructs. Models controlled for age, sex, and baseline body fat. Separate models were used to investigate the associations between bedroom TV and the same dependent variables. RESULTS/ANTICIPATED RESULTS: Participants reported an average of 13.3±10.8 hours/week of TV viewing, with 33.3% reporting a TV in the bedroom. There were no differences in age, sex, or race among the quartiles of TV viewing or between those who did and did not have a bedroom TV. Adults with a bedroom TV did not differ in hours/week of TV viewing compared with those without a bedroom TV. Amount of TV viewing was associated with higher systolic blood pressure at baseline (p=0.05) but with no other anthropometric or body composition indices nor with change in body composition over the 2-year period. Adults with a bedroom TV reported higher craving for sweets at baseline (p=0.03). Amount of TV viewing was related to lower consumption of vegetables (p=0.04) and fruit or fruit juice (p=0.03) at Year 2, but there was no association with total calorie consumption. TV viewing and bedroom TV were not related to dietary restraint, disinhibition, or hunger at either time point. DISCUSSION/SIGNIFICANCE OF IMPACT: Adults who watched more TV consumed fewer fruits and vegetables, and those with a TV in the bedroom reported higher craving for sweets. Though there were no observed relationships between TV habits and body composition change, the associations with cravings and food consumption warrant further exploration. Querying young adults’ TV and media use habits in clinical settings may alert physicians to those at risk of developing poor dietary habits.

Abstract Objective: This study aimed to identify the prevalence and factors associated with body mass index (BMI) in children aged 9-11 years. Methods: The study is part of the International Study of Childhood Obesity Lifestyle and the Environment (ISCOLE). Body composition was determined using the bipolar bioimpedance technique. The mean BMI value was categorized as recommended by the World Health Organization. For seven consecutive days, participants used an accelerometer to objectively monitor sedentary behavior (SB) and moderate to vigorous physical activity. Individual factors (anthropometric and behavioral), family aspects, and family and school environment were provided by participants and parents and were analyzed by multilevel linear regression adjusted for gender, ethnicity, school, number of siblings, and total annual family income. Results: The mean BMI was 20.1 kg/m2, and 51.8% of the children were overweight/obese (50.3% boys, 53.4% girls, p = 0.014). Considering all participants, the associated factors of BMI were body fat percentage (BF%, β = 0.0216, p < 0.001) and screen time (ST, β = 0.0050, p = 0.006). In boys, the associated factors were BF% (β = 0.0209, p < 0.001), ST (β = 0.006, p = 0.036), and healthy eating policies or practices (β = 0.0276, p = 0.025). In girls, only BF% was associated (β = 0.0221, p < 0.001) with BMI. Conclusions: High prevalence of overweight/obesity was observed in children from São Caetano do Sul. Different associated factors were identified between the genders, with only BF% being common in both genders.