Introduction: Studies such as IDEFICS (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) seek to compare data across several different countries. Therefore, it is important to confirm that body composition indices, which are subject to intra-and inter-individual variation, are measured using a standardised protocol that maximises their reliability and reduces error in analyses. Objective: To describe the standardisation and reliability of anthropometric measurements. Both intra-and inter-observer variability of skinfold thickness (triceps, subscapular, biceps, suprailiac) and circumference (neck, arm, waist, hip) measurements were investigated in five different countries. Methods: Central training for fieldwork personnel was carried out, followed by local training in each centre involving the whole survey staff. All technical devices and procedures were standardised. As part of the standardisation process, at least 20 children participated in the intra-and inter-observer reliability test in each centre. A total of 125 children 2-5 years of age and 164 children 6-9 years of age took part in this study, with a mean age of 5.4 (±1.2) years. Results: The intra-observer technical error of measurement (TEM) was between 0.12 and 0.47 mm for skinfold thickness and between 0.09 and 1.24 cm for circumference measurements. Intra-observer reliability was 97.7% for skinfold thickness (triceps, subscapular, biceps, suprailiac) and 94.7% for circumferences (neck, arm, waist, hip). Inter-observer TEMs for skinfold thicknesses were between 0.13 and 0.97 mm and for circumferences between 0.18 and 1.01 cm. Inter-observer agreement as assessed by the coefficient of reliability for repeated measurements of skinfold thickness and circumferences was above 88% in all countries. Conclusion: In epidemiological surveys it is essential to standardise the methodology and train the participating staff in order to decrease measurement error. In the framework of the IDEFICS study, acceptable intra-and inter-observer agreement was achieved for all the measurements.
Poor physical fitness in children is associated with the development of cardio-metabolic risk factors. Based on our results, this risk might be modified by improving mainly cardio-respiratory fitness and lower-limb muscular strength.
Background A supportive environment is a key factor in addressing the issue of health among older adults. There is already sufficient evidence that objective and self-reported measures of the neighborhood environment should be taken into account as crucial components of active aging, as they have been shown to influence physical activity; particularly in people aged 60+. Thus, both could inform policies and practices that promote successful aging in place. An increasing number of studies meanwhile consider these exposures in analyzing their impact on physical activity in the elderly. However, there is a wide variety of definitions, measurements and methodological approaches, which complicates the process of obtaining comparable estimates of the effects and pooled results. The aim of this review was to identify and summarize these differences in order to emphasize methodological implications for future reviews and meta analyzes in this field and, thus, to create a sound basis for synthesized evidence. Methods A systematic literature search across eight databases was conducted to identify peer-reviewed articles examining the association of objective and perceived measures of the neighborhood environment and objectively measured or self-reported physical activity in adults aged ≥ 60 years. Two authors independently screened the articles according to predefined eligibility criteria, extracted data, and assessed study quality. A qualitative synthesis of the findings is provided. Results Of the 2967 records retrieved, 35 studies met the inclusion criteria. Five categories of methodological approaches, numerous measurement instruments to assess the neighborhood environment and physical activity, as well as several clusters of definitions of neighborhood, were identified. Conclusions The strength of evidence of the associations of specific categories of environmental attributes with physical activity varies across measurement types of the outcome and exposures as well as the physical activity domain observed and the operationalization of neighborhood. The latter being of great importance for the targeted age group. In the light of this, future reviews should consider these variations and stratify their summaries according to the different approaches, measures and definitions. Further, underlying mechanisms should be explored.
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