Despite the health benefits associated with physical activity (PA), screen time reduction, and sleep quantity and quality, the relationships between PA, screen time, and sleep quantity and quality remain unclear in adolescents. The present study is a cross-sectional analysis of data from adolescents aged 16–19 years who participated in the 2005–2006 National Health and Nutrition Examination Survey (n = 542). Multivariable logistic regression models, adjusted for confounders, examined the relationship between objectively measured PA, self-reported screen time, and sleep quantity and quality. Respondents who met the current PA recommendation had 50% lower odds of having sufficient sleep (≥8 h) than those not meeting the recommendation (OR = 0.50, 95% CI: 0.26, 0.94). Respondents who met the screen time recommendation (≤2 h/day) had 55% lower odds of reporting poor sleep quality than those whose screen time exceeded the recommendation (OR = 0.45, 95% CI: 0.22, 0.91), with similar patterns observed for females and males. However, males who met both PA and screen time recommendations had 73% lower odds of reporting poor sleep quality than males who met neither recommendation (OR = 0.27, 95% CI: 0.07, 0.99). In conclusion, PA and screen time are associated with sleep quantity or sleep quality in adolescents, and there are differences in these associations by sex.

Background: It remain unclear that the association between weight status, weight perception, weight satisfaction and the clustering of physical activity (PA) and dietary behaviors in adolescents. Method: A cross-sectional analysis of National Health and Nutrition Examination Survey and the US Department of Agriculture’s Food Patterns Equivalents 2007–2014 data from adolescents aged 12–17 years (n = 2965) was conducted. Multivariable logistic regression models adjusted for demographic characteristics examined the association between weight status, weight perception, weight satisfaction, and the four created lifestyle groups (healthier behaviors, healthier diet only, physically active only, unhealthier behaviors). Results: Males with obesity were more likely to be in the healthier diet only group than males with a normal weight (OR = 1.90, 95% CI: 1.02, 3.52). Similar patterns were found in males who perceived themselves as being overweight or having obesity (OR = 2.09, 95% CI: 1.09, 3.99) and males with obesity who perceived their weight status accurately (OR = 2.33, 95% CI: 1.12, 4.88). Female respondents who were satisfied with their weight were 59% less likely to be in the healthier diet only group than healthier behaviors group compared with females who were weight dissatisfied (OR = 0.41, 95% CI: 0.23, 0.75). This pattern was not observed in males. Conclusions: Clustering PA and dietary behaviors were associated with weight status and weight perception for males but not females. Weight satisfaction was associated with clustered PA and dietary behaviors for females. These findings are important for obesity prevention policies and programs to better address adolescents’ obesity and reduce health disparities in this population.

Background: A growing body of research shows that diet quality and physical activity (PA) are associated with health-related quality of life (HRQOL). However, no study to date has assessed this association using the Healthy Eating Index-2015 as a measure of diet quality. Furthermore, few studies have examined the association between PA dose and HRQOL among a nationally representative sample of older adults. Objectives: To investigate the relationship between diet quality, physical activity, and HRQOL. Design: A cross-sectional analysis was conducted using data obtained from 5,311 adults aged 60+ years who took part in the National Health and Nutrition Examination Survey between 2007 and 2014. Measurements: HRQOL was assessed by general health status, and number of physically unhealthy days, mentally unhealthy days, and inactive days in past 30 days. Diet quality was assessed by the Healthy Eating Index-2015 using data generated by two 24-hour dietary recalls. PA was measured by the Global Physical Activity Questionnaire. Multivariate logistic/or linear regression models were used to examine the low PA levels but not fewer mentally unhealthy days. Conclusions: Among older adults in this study, eating a healthier diet and being physically active were associated with better general health and reporting fewer physical unhealthy days and inactive days. Study results provide valuable information that could inform policies, programs and interventions designed to improve HRQOL in older adults and reduce potentially preventable health disparities.

The association between adolescents' weight perception and their physical activity (PA) and sedentary behaviors remains unclear. Therefore, these associations were explored using data from 2438 adolescents aged 12–19 years who participated in the National Health and Nutrition Examination 2011–2014 Survey. Respondents reported weight perception, and their weight perception accuracy was determined by examining whether the measured weight and perceived weight were concordant. Respondents also reported sedentary time (sitting time and screen time), PA, and intention to lose weight. Linear and logistic regression models were conducted to determine whether adolescents' PA, sedentary behaviors, and weight loss intention differed by weight perception and weight perception accuracy adjusted for demographic variables accounting for complex sampling. About one-quarter (21.4%) of the respondents had obesity. For respondents who perceived themselves as being overweight/fat, despite greater weight loss intention, males reported more sitting time (512.7 ± 16.3 versus 474.1 ± 10.2 minutes/day, p < 0.05) and females reported less PA (48.7 ± 5.0 versus 64.6 ± 3.3 minutes/day, p < 0.05) than respondents who perceived themselves as being normal weight. Similar patterns were observed for weight perception accuracy among individuals with obesity. Study results show that perceiving oneself as being overweight/fat regardless of accuracy was associated with more sedentary time for males or less PA for females despite higher weight loss intention.

This study employed a quasi-experimental design in a community-based study translating the results of our recent findings on the combined effects of Tai Chi and weight loss on physical function and coronary heart disease (CHD) risk factors. A 16-week intervention was conducted to assess the impact of Tai Chi plus a behavioral weight loss program (TCWL, n = 29) on obese (body mass index [BMI] = 35.4 ± 0.8 kg/m²) older (68.2 ± 1.5 yr.) women compared to a control group (CON, n = 9, BMI = 38.0 ± 1.5 kg/m², 65.6 ± 2.7 yr.), which was asked to maintain their normal lifestyle. The TCWL group lost weight (1.6 ± 2.9 kg, P = 0.006) while the CON group did not (1.2 ± 1.9 kg, P = 0.106). Physical functioning as measured by the short physical performance battery improved in TCWL when compared to the CON group (β = 1.94, 95% Confidence Interval [CI]: 1.12, 2.76, P < 0.001). TCWL also improved in sit-and-reach flexibility (β = -2.27, 95% CI: -4.09, -0.46, P = 0.016), body fat mass (BMI, β = -0.65, 95% CI: -1.03, -0.26, P = 0.002), waist circumference (β = -1.78, 95% CI: -2.83, -0.72, P = 0.002), systolic blood pressure (β = -16.41, 95% CI: -21.35, -11.48, P < 0.001), and diastolic blood pressure (β = -9.52, 95% CI: -12.65, -6.39, P < 0.001). Thus, TCWL intervention may represent an effective strategy to improve physical function and ameliorate CHD risk in the older adult population.

ObjectivesTo determine if adults with overweight or obesity received counselling from their healthcare providers (HCPs) to lose weight and/or adopt healthful behaviours associated with weight loss, and whether they took action on their HCPs’ recommendations.DesignCross-sectional analysis of 2011–2018 National Health and Nutrition Examination Survey (NHANES) data.SampleNHANES respondents aged 18+ who were overweight/obese and had seen an HCP in the previous 12 months (n=13 158).MethodsRespondents reported if their HCPs recommended they control/lose weight, increase exercise/physical activity (PA) and/or reduce fat/calorie intake, and if they adopted the offered recommendation(s). Weighted logistic regression models examined receipt of HCP counselling by sex, age, race/ethnicity, and weight status accounting for demographic characteristics and complex sampling. Similar analyses examined reported adoption of HCPs’ recommendations.ResultsThe sample was 53.1% women, 45.0% were overweight and 55.0% had obesity. In total, 40.4% received counselling to control/lose weight, 49.5% to increase exercise/PA and 38.9% to reduce fat/calorie intake. The following groups were less likely (p<0.001) to receive counselling: men; younger adults (aged 18–39) versus middle-aged (aged 40–64) and older adults (aged 65+); White versus Black and Hispanic respondents; overweight respondents versus respondents with obesity. Approximately half of those advised to make changes reported doing so (53.6% controlled/lost weight, 57.3% increased exercise/PA, 51.8% reduced fat/calorie intake). Differences in the adoption of recommendations were identified by sex, age group, race/ethnicity and weight status (all p<0.05); women, middle-aged and older adults, Black and Hispanic respondents and individuals with obesity were more likely to adopt one or more recommendations.ConclusionMost respondents did not receive HCP counselling, and approximately half of those who received counselling reported taking action. HCPs may need training to provide counselling and to offer recommendations tailored to the social contexts of populations less likely to adopt weight control related recommendations.

There is a need for efficacious interventions to reduce the prevalence of childhood obesity, and a limited body of research suggests that collaborative community-based programs designed for children and their caregivers may be effective in reducing obesity rates. This paper reports the results of a community-based obesity intervention, South County Food, Fitness and Fun (SCFFF), designed for preadolescent children who are overweight or obese and their caregivers. SCFFF was developed in response to community concerns. Families were referred to the program by their physician and participated in the program at no cost. The 16-week intervention includes weekly group nutrition and physical activity sessions. Analyses determined that 65 out of the 97 children who completed SCFFF provided 2-year follow-up data and had reduced BMI z-scores over 2 years following the intervention. These participants decreased their energy, fat, carbohydrate, saturated fat, and sodium intake and increased core body strength and endurance from baseline to the end of the intervention. SCFFF was effective in reducing relative weight and improving diet and core muscle strength and endurance in children who are overweight or obese.

BACKGROUND: There is a need to assess longitudinal trends in physical function and to understand the prevalence of physical function status in the older population using objectively measured physical function. Therefore, the primary purpose of this study was to examine longitudinal sex-specific physical function trends and prevalence of physical function status by age, race/ethnicity, and weight status in older adults, aged 65 years and older. METHODS: The present study used longitudinal data from the National Health and Aging Trends Study. Physical function was measured annually from 2011 to 2018 using the Short Physical Performance Battery, and classified as poor (0-6), fair (7-9), or good (10-12). Mixed effect regression and generalized estimating equation models were used to estimate unadjusted trends and annual changes in physical function, adjusting for confounders and accounting for complex sampling. RESULTS: Respondents' physical function declined over time regardless of sex, age, race/ethnicity, and weight status (P < .001). Respondents aged 75 to 84 years (males: β = −.18; 95% confidence interval (CI) = −.22 to −.13; females: β = −.23; 95% CI = −.27 to −.20) and 85 years and older (males: β = −.39; 95% CI = −.47 to −.30; females: β = −.33; 95% CI = −.39 to −.28) had a greater annual physical function rate of decline than respondents aged 65 to 74 years. Respondents aged 75 years and older also had a greater annual increase in the proportion classified as having poor physical function than respondents aged 65 to 74 years (P < .001), regardless of sex. Compared with non-Hispanic whites, Hispanic females had a lower annual physical function rate of decline (β = .14; 95% CI = 0.07-0.20), and Hispanic and/or non-Hispanic blacks had slower annual changes in the proportion classified as having good physical function (P < .05). Compared with normal weight males, overweight males had lower annual changes in physical function (P = .003) and proportion of those with poor physical function (P = .004), but no differences between weight status were observed in females. CONCLUSIONS: Physical function declines with age, but temporal changes in physical function and physical function status varied by sex, age, race/ethnicity, and weight status.