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Biomedical subjects

Brian E Saelens

Publications and source records attributed to Brian E Saelens.

17 recordsLinked to original sources

Visceral abdominal fat is correlated with whole-body fat and physical activity among 8-y-old children at risk of obesity.

BACKGROUND: Abdominal fat is more related to health risk than is whole-body fat. Determining the factors related to children's visceral fat could result in interventions to improve child health. OBJECTIVE: Given the effects of physical activity on adults' visceral fat, it was hypothesized that, after accounting for whole-body fat, physical activity would be inversely related to children's visceral (VAT), but not to subcutaneous (SAT), abdominal adipose tissue. DESIGN: In this cross-sectional observational study conducted in forty-two 8-y-old children (21 boys, 21 girls) at risk of obesity [>75th body mass index (BMI) percentile, with at least one overweight parent], familial factors (eg, maternal BMI), historic weight-related factors (eg, birth weight), and the children's current physical activity (self-reported and measured with accelerometry) and diet were examined as potential correlates of the children's whole-body composition (measured with BMI and dual-energy X-ray absorptiometry) and abdominal fat distribution (measured by magnetic resonance imaging). RESULTS: Accelerometer-measured physical activity was related to whole-body fat (r = -0.32, P < 0.10), SAT (r = -0.29, P < 0.10), and VAT (r = -0.43, P < 0.05). In regression models, whole-body fat was positively associated with and the only significant correlate of SAT. Whole-body fat was positively related and accelerometer-measured physical activity was negatively and independently related to the children's VAT. CONCLUSIONS: Both SAT and VAT in 8-y-old children at risk of obesity are most closely associated with whole-body fat. However, after control for whole-body fat, greater physical activity is only associated with lower VAT, not SAT, in these children.

Absorptiometry, Photon↗

Active commuting to school: Associations with environment and parental concerns.

PURPOSE: This study examined the association of objective and perceived neighborhood environmental characteristics and parent concerns with active commuting to school, investigated whether parental concerns varied by environmental characteristics, and compared the association of the perceived environment, parental concerns, and objective environment on the outcome active commuting to school. METHODS: Randomly selected parents of children (aged 5-18 yr), in neighborhoods chosen for their variability in objectively measured walkability and income, completed questionnaires about their neighborhood environment, concerns about children walking to school, and children's behavior (N = 259). Objective measures of the environment were available for each participant and each neighborhood. Logistic regression analyses were used to investigate the relationships among environment, parental concerns, and walking or biking to or from school at least once a week. RESULTS: A parental concerns scale was most strongly associated with child active commuting (odds ratio: 5.2, 95% CI: 2.71-9.96). In high-income neighborhoods, more children actively commuted in high-walkable (34%) than in low-walkable neighborhoods (23%) (odds ratio: 2.1, 95% CI: 1.12-3.97), but no differences were noted in low-income neighborhoods. Parent concerns and neighborhood aesthetics were independently associated with active commuting. Perceived access to local stores and biking or walking facilities accounted for some of the effect of walkability on active commuting. CONCLUSION: Both parent concerns and the built environment were associated with children's active commuting to school. To increase active commuting to school, interventions that include both environmental change and education campaigns may be needed.

Adolescent↗

Neighborhood Environment Walkability Scale: validity and development of a short form.

PURPOSE: The aim of this study was to examine the factorial and criterion validity of the Neighborhood Environment Walkability Scale (NEWS) and to develop an abbreviated version (NEWS-A). METHODS: A stratified two-stage cluster sample design was used to recruit 1286 adults. The sample was drawn from residential addresses within eight high- and eight low-walkable neighborhoods matched for socioeconomic status. Subjects completed the NEWS and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire. RESULTS: Multilevel confirmatory factor analysis was used to develop measurement models of the NEWS and NEWS-A. Six individual-level and five blockgroup-level factors were identified. Factors/scales gauging presence of diversity of destinations, residential density, walking infrastructure, aesthetics, traffic safety, and crime were positively related to walking for transport. Aesthetics, mixed destinations, and residential density were associated with walking for recreation. CONCLUSIONS: The NEWS and NEWS-A possess adequate levels of factorial and criterion validity. Alternative methods of scoring for different purposes are presented.

Adult↗

Linking objectively measured physical activity with objectively measured urban form: findings from SMARTRAQ.

BACKGROUND: To date, nearly all research on physical activity and the built environment is based on self-reported physical activity and perceived assessment of the built environment. OBJECTIVE: To assess how objectively measured levels of physical activity are related with objectively measured aspects of the physical environment around each participant's home while controlling for sociodemographic covariates. METHODS: Objective measures of the built environment unique to each household's physical location were developed within a geographic information system to assess land-use mix, residential density, and street connectivity. These measures were then combined into a walkability index. Accelerometers were deployed over a 2-day period to capture objective levels of physical activity in 357 adults. RESULTS: Measures of land-use mix, residential density, and intersection density were positively related with number of minutes of moderate physical activity per day. A combined walkability index of these urban form factors was significant (p =0.002) and explained additional variation in the number of minutes of moderate activity per day over sociodemographic covariates. Thirty-seven percent of individuals in the highest walkability index quartile met the > or =30 minutes of physical activity recommended, compared to only 18% of individuals in the lowest walkability quartile. Individuals in the highest walkability quartile were 2.4 times more likely (confidence interval=1.18-4.88) than individuals in the lowest walkability quartile to meet the recommended > or =30 minutes of moderate physical activity per day. CONCLUSIONS: This research supports the hypothesis that community design is significantly associated with moderate levels of physical activity. These results support the rationale for the development of policy that promotes increased levels of land-use mix, street connectivity, and residential density as interventions that can have lasting public health benefits.

Adult↗

Prevalence, characteristics, and correlates of teasing experiences among overweight children vs. non-overweight peers.

OBJECTIVE: Information regarding the prevalence, nature, sources, and psychosocial correlates of teasing was obtained for overweight (OV) children (10 to 14 years of age) vs. non-overweight (non-OV) peers. It was hypothesized that weight-related teasing would be negatively correlated with self-esteem in specific domains and with enjoyment of physical/social activities and positively correlated with loneliness, bulimic behaviors, body dissatisfaction, and enjoyment of sedentary/isolative activities. RESEARCH METHODS AND PROCEDURES: Teasing experiences and psychosocial correlates were assessed among OV children from a fitness camp and a demographically similar school sample of non-OV children. RESULTS: Among the OV children, appearance-related teasing was more prevalent, frequent, and upsetting, involved disparaging nicknames focusing more on weight rather than less stigmatized aspects of appearance, and more often perpetrated by peers in general rather than a specific peer. Degree of teasing within the full sample was significantly associated with higher weight concerns, more loneliness, poorer self-perception of one's physical appearance, higher preference for sedentary/isolative activities, and lower preference for active/social activities, all but the latter association holding up above and beyond actual weight status and demographics. Among OV children, teasing was associated with bulimic behaviors. Associations with type of teasing showed specificity, with weight-related teasing predicting weight and appearance variables and competency-related teasing related to social domain factors. DISCUSSION: When frequency, intensity, emotional impact, and stigmatized content are examined, findings indicate that teasing is more severe for OV children. Effective interventions are needed to help victims cope with and prevent further weight-related teasing, which may improve peer functioning, enhance weight control efforts, and reduce risk for future eating disturbance.

Adolescent↗

Psychological adjustment of obese youth presenting for weight management treatment.

OBJECTIVE: To determine the prevalence of psychological maladjustment in clinic-based treatment-seeking obese children and adolescents (BMI > or = 95th percentile) and the degree to which maternal, demographic, and youth factors correlate to the youths' psychological adjustment. RESEARCH METHODS AND PROCEDURES: Anthropometrics, demographics (race, sex, insurance status), measures of youth psychological adjustment (self- and mother-report; Behavior Assessment System for Children), and maternal self-report of psychological distress (Symptom Checklist 90-Revised) were collected from 121 obese children and adolescents (55% white, 45% black) and their mothers. RESULTS: Approximately one-third of youths self-reported some psychological maladjustment, but two-thirds of youth were described by their mothers as experiencing some degree of psychological maladjustment. Adjustment difficulties were specific to social functioning, low self-esteem, and internalizing symptoms. Forty-one percent of mothers of child participants and 56% of mothers of adolescent participants reported clinically significant psychological distress. Youth self-report and mother-report of youths' psychological difficulties were often most strongly associated with mothers' level of psychological distress and/or family socioeconomic status rather than to youth characteristics (e.g., percent overweight, race). DISCUSSION: Psychological maladjustment levels among obese youth and their mothers were higher in this clinic-based sample than in treatment research-based samples. Present correlate findings extended to obese adolescents and reaffirm a potent association between youth self-report of their own psychological adjustment and their mother's level of psychological distress. Demographic characteristics and youth weight status were not consistent correlates of youths' psychological functioning. Findings have implications for the translation of empirically supported pediatric obesity interventions to clinic-based treatment samples.

Adolescent↗

Measuring the environment for friendliness toward physical activity: a comparison of the reliability of 3 questionnaires.

OBJECTIVES: We tested the reliability of 3 instruments that assessed social and physical environments. METHODS: We conducted a test-retest study among US adults (n = 289). We used telephone survey methods to measure suitableness of the perceived (vs objective) environment for recreational physical activity and nonmotorized transportation. RESULTS: Most questions in our surveys that attempted to measure specific characteristics of the built environment showed moderate to high reliability. Questions about the social environment showed lower reliability than those that assessed the physical environment. Certain blocks of questions appeared to be selectively more reliable for urban or rural respondents. CONCLUSIONS: Despite differences in content and in response formats, all 3 surveys showed evidence of reliability, and most items are now ready for use in research and in public health surveillance.

Adult↗

Overweight children's barriers to and support for physical activity.

OBJECTIVE: As the epidemic of overweight increases among youth, research needs to examine factors that may influence children's participation in weight-related health behaviors. This study examined overweight children's perceived barriers to and support for physical activity compared with nonoverweight children. RESEARCH METHODS AND PROCEDURES: Barriers to and support for physical activity were examined among 84 overweight children attending a summer fitness camp or a university-based weight loss clinic. Barriers and support levels were then compared with those of 80 nonoverweight children of a similar age range. RESULTS: Body-related barriers were the most predominant barrier type among overweight youth, especially among overweight girls. Overweight children, particularly girls, reported significantly higher body-related, resource, and social barriers to physical activity compared with nonoverweight children and lower levels of adult support for physical activity. DISCUSSION: Overweight children may be particularly vulnerable to body-related barriers to physical activity, and reducing such barriers may serve as physical activity intervention points most relevant for overweight youth. Future interventions may also benefit from enhancing support for physical activity from adults and peers.

Adolescent↗

Environmental correlates of walking and cycling: findings from the transportation, urban design, and planning literatures.

Research in transportation, urban design, and planning has examined associations between physical environment variables and individuals' walking and cycling for transport. Constructs, methods, and findings from these fields can be applied by physical activity and health researchers to improve understanding of environmental influences on physical activity. In this review, neighborhood environment characteristics proposed to be relevant to walking/cycling for transport are defined, including population density, connectivity, and land use mix. Neighborhood comparison and correlational studies with nonmotorized transport outcomes are considered, with evidence suggesting that residents from communities with higher density, greater connectivity, and more land use mix report higher rates of walking/cycling for utilitarian purposes than low-density, poorly connected, and single land use neighborhoods. Environmental variables appear to add to variance accounted for beyond sociodemographic predictors of walking/cycling for transport. Implications of the transportation literature for physical activity and related research are outlined. Future research directions are detailed for physical activity research to further examine the impact of neighborhood and other physical environment factors on physical activity and the potential interactive effects of psychosocial and environmental variables. The transportation, urban design, and planning literatures provide a valuable starting point for multidisciplinary research on environmental contributions to physical activity levels in the population.

Bicycling↗

Neighborhood-based differences in physical activity: an environment scale evaluation.

OBJECTIVES: This study evaluated a neighborhood environment survey and compared the physical activity and weight status of the residents in 2 neighborhoods. METHODS: On 2 occasions, 107 adults from neighborhoods with differing "walkability" were selected to complete a survey on their neighborhood environment. Physical activity was assessed by self-report and by accelerometer; height and weight were assessed by self-report. RESULTS: Neighborhood environment characteristics had moderate to high test-retest reliabilities. Residents of high-walkability neighborhoods reported higher residential density, land use mix, street connectivity, aesthetics, and safety. They had more than 70 more minutes of physical activity and had lower obesity prevalence (adjusted for individual demographics) than did residents of low-walkability neighborhoods. CONCLUSIONS: The reliability and validity of self-reported neighborhood environment subscales were supported. Neighborhood environment was associated with physical activity and overweight prevalence.

Adult↗

A randomized comparison of group cognitive-behavioral therapy and group interpersonal psychotherapy for the treatment of overweight individuals with binge-eating disorder.

BACKGROUND: Cognitive-behavioral therapy (CBT) has documented efficacy for the treatment of binge eating disorder (BED). Interpersonal psychotherapy (IPT) has been shown to reduce binge eating but its long-term impact and time course on other BED-related symptoms remain largely unknown. This study compares the effects of group CBT and group IPT across BED-related symptoms among overweight individuals with BED. METHODS: One hundred sixty-two overweight patients meeting DSM-IV criteria for BED were randomly assigned to 20 weekly sessions of either group CBT or group IPT. Assessments of binge eating and associated eating disorder psychopathology, general psychological functioning, and weight occurred before treatment, at posttreatment, and at 4-month intervals up to 12 months following treatment. RESULTS: Binge-eating recovery rates were equivalent for CBT and IPT at posttreatment (64 [79%] of 81 vs 59 [73%] of 81) and at 1-year follow-up (48 [59%] of 81 vs 50 [62%] of 81). Binge eating increased slightly through follow-up but remained significantly below pretreatment levels. Across treatments, patients had similar significant reductions in associated eating disorders and psychiatric symptoms and maintenance of gains through follow-up. Dietary restraint decreased more quickly in CBT but IPT had equivalent levels by later follow-ups. Patients' relative weight decreased significantly but only slightly, with the greatest reduction among patients sustaining recovery from binge eating from posttreatment to 1-year follow-up. CONCLUSIONS: Group IPT is a viable alternative to group CBT for the treatment of overweight patients with BED. Although lacking a nonspecific control condition limits conclusions about treatment specificity, both treatments showed initial and long-term efficacy for the core and related symptoms of BED.

Adult↗

Behavioral weight control for overweight adolescents initiated in primary care.

OBJECTIVE: This study evaluates the post-treatment and short-term follow-up efficacy of, as well as participant satisfaction for, a 4-month behavioral weight control program for overweight adolescents initiated in a primary care setting and extended through telephone and mail contact. RESEARCH METHODS AND PROCEDURES: 44 overweight adolescents were randomly assigned to either a multiple component behavioral weight control intervention (Healthy Habits [HH]; n = 23) or a single session of physician weight counseling (typical care [TC]; n = 21). Weight, height, dietary intake, physical activity, sedentary behavior, and problematic weight-related and eating behaviors and beliefs were assessed before treatment, after the 4-month treatment, and at 3-month follow-up. Participant satisfaction and behavioral skills use were measured. RESULTS: HH adolescents evidenced better change in body mass index z scores to post-treatment than TC adolescents. Body mass index z scores changed similarly in the conditions from post-treatment through follow-up. Behavioral skills use was higher among HH than TC adolescents, and higher behavioral skills use was related to better weight outcome. Energy intake, percentage of calories from fat, physical activity, sedentary behavior, and problematic weight-related or eating behaviors/beliefs did not differ by condition or significantly change over time independent of condition. The behavioral intervention evidenced good feasibility and participant satisfaction. DISCUSSION: A telephone- and mail-based behavioral intervention initiated in primary care resulted in better weight control efficacy relative to care typically provided to overweight adolescents. Innovative and efficacious weight control intervention delivery approaches could decrease provider and participant burden and improve dissemination to the increasing population of overweight youth.

Adolescent↗

Home environmental influences on children's television watching from early to middle childhood.

Identifying correlates of children's television (TV) watching could help identify strategies to reduce children's TV watching and impact children's weight status. Children's TV time and home environment factors were assessed longitudinally among 169 families with children followed from 6 to 12 years of age. TV watching increased with age, as did the number of in-home TVs and the presence of videocassette recorders (VCRs), the frequency of meal eating while watching TV, and the percentage of children with bedroom TVs. Greater meal eating while watching TV was consistently related to overall TV watching and increases in TV watching over time. The number of in-home TVs and the presence of a bedroom TV were less consistent correlates. TV watching was related to weight status when children were younger, and when children were older, more than 2 hours of TV daily was a risk factor for higher weight. Modifying TV access, particularly by reducing the frequency of meals eaten while watching TV, could promote lower children's TV watching and adiposity.

Body Weight↗

Physician weight counseling for adolescents.

Adolescent obesity prevalence is increasing, with minimal study of physician weight counseling with youth. This study examines adolescents' (n=110) perceptions of physicians' weight counseling. Overweight adolescents (> or =85th percentile for body mass index, BMI) report receiving counseling more than nonoverweight adolescents. Physicians more often have counseled obese (> or =95th BMI percentile) than overweight but not obese adolescents (85th-94th BMI percentile). Prior counseling and adolescents' ethnicity were related to greater perceived physician concern and adolescent receptivity to future counseling. Overweight adolescents report attempting weight loss strategies at rates similar to recommendations, but recommendations for specific weight control behaviors do not increase the likelihood of adolescent attempts. Clin Pediatr. 2002;41:575-585

Adolescent↗

Environmental correlates of physical activity in a sample of Belgian adults.

PURPOSE: This study investigated the variance in sitting, walking, and moderate and vigorous physical activity explained by neighborhood design and recreational environmental variables above and beyond the variance accounted for by individual demographic variables. DESIGN: Cross-sectional analyses of self-reported survey data. SETTING: A random sample of inhabitants of Ghent, Belgium, aged 18-65 years, was drawn. SUBJECTS: Five hundred twenty-one adults completed questionnaires (52.1% response rate). The average age of the sample was 41 years, and 48.2% were female. MEASURES: A questionnaire developed to assess neighborhood design and recreational environmental variables with a total of 81 items was administered. The environmental questionnaire showed acceptable to good reliability and acceptable validity. The previously validated International Physical Activity Questionnaire (IPAQ) was used to quantify physical activity in the past 7 days. Additional demographic information was also obtained. RESULTS: Regression analyses showed that environmental variables were related to all types of physical activity in both sexes. However, the range of variance explained by the models including demographic and environmental variables was low, only 5% to 13%. Minutes of walking and of moderate-intensity activity were related to quality of sidewalks and accessibility of shopping and public transportation. Vigorous physical activity was related to presence of activity supplies in the home and number of convenient activity facilities outside the home. CONCLUSIONS: Both neighborhood design and recreational environment variables had small but significant associations with multiple types of physical activity in a sample of Belgian adults.

Adolescent↗

The association of neighborhood design and recreational environments with physical activity.

PURPOSE: To determine the association of neighborhood design factors and recreational environments with physical activity. METHODS: Randomly selected adults (n = 102, 52% female, 81% white, mean age = 48 years) completed a survey of eight neighborhood design variables, convenient recreational facilities, and availability of home equipment. Physical activity was measured by self-report and 7 days of accelerometer monitoring. RESULTS: Residential density and an overall environment index were significantly related to both vigorous-intensity self-reported (r = .35 and .28, respectively) and objectively measured physical activity (r = .39 and .23, respectively). Home equipment was correlated with self-reported total (r = .34) and vigorous leisure-time physical activity (r = .27). The vigorous and total activity accelerometer measures were correlated with street connectivity (r = .25 and .21, respectively). DISCUSSION: Few self-reported neighborhood design factors and recreational environment variables were correlated with physical activity, and some findings were unexpected.

Adult↗

Healthy nutrition environments: concepts and measures.

The authors provide a conceptual model of a healthy nutrition environment, then review the types of measures required to assess various aspects of this environment. Measures fall into priority categories of consumer and community environments.

Adult↗