The International Journal Of Behavioral Nutrition And Physical Activity[JOURNAL]
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200 papers
Ecological momentary assessment of meal context and food types contributing to salt intake at meals.
Shinozaki N, Murakami K, Masayasu S … +1 more , Sasaki S
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40579711 · Full text
BACKGROUND: Salt (sodium) intake can vary across meals depending on the meal context and food types, including what and how much was consumed and where, when, and with whom it was consumed. However, their dynamic associa...
BACKGROUND: Salt (sodium) intake can vary across meals depending on the meal context and food types, including what and how much was consumed and where, when, and with whom it was consumed. However, their dynamic associations remain unclear. This study examined how meal context and food types are associated with salt intake at meals. METHODS: This cross-sectional analysis used data from 2757 adults aged 18–79 years. Ecological momentary assessment was conducted using eight-day dietary records to obtain information on meal context, food types, and salt intake. RESULTS: Multilevel linear regression analysis of 63,239 meals showed a higher absolute salt intake (g/meal) at lunch (β: 0.47, 95% CI: 0.44, 0.51) and dinner (β: 0.84, 95% CI: 0.80, 0.88) than at breakfast. In addition, salt intake from meals eaten on non-working or non-school days (β: 0.10, 95% CI: 0.06, 0.13), in restaurants (β: 0.40, 95% CI: 0.34, 0.45), and with one other person (β: 0.08, 95% CI: 0.05, 0.12) was higher than that from meals eaten on working or school days, at home, and alone, respectively. Regarding food types, salt intake was significantly higher in meals containing staple foods (e.g., rice and bread), especially noodles (β: 2.29, 95% CI: 2.23, 2.36), as well as soup (β: 1.06, 95% CI: 1.03, 1.09), pickles (β: 0.72, 95% CI: 0.68, 0.75), reduced-salt seasonings (β: 0.35, 95% CI: 0.23, 0.47), herbs and spices (β: 0.13, 95% CI: 0.10, 0.16), citrus juice and vinegar (β: 0.30, 95% CI: 0.26, 0.34), moderately processed meat and seafood (β: 0.59, 95% CI: 0.56, 0.62), highly processed meat and seafood (β: 0.58, 95% CI: 0.55, 0.61), and alcoholic beverages (β: 0.36, 95% CI: 0.32, 0.41) than in meals without these foods. Consumption of salt-based seasonings and vegetables was positively associated with salt intake, whereas consuming fruit was associated with lower salt intake (β: -0.12, 95% CI: -0.15, -0.09). Using salt intake density (g/100 kcal) per meal instead of absolute salt intake showed generally similar associations. CONCLUSIONS: Meal context and food types were associated with salt intake. These findings would be useful for developing practical strategies for reducing salt intake.
Are we working (too) comfortably?: the systematic development of an intervention to support workers to move more while working at home.
Sivaramakrishnan D, Fitzsimons C, Morton S … +3 more , Manner J, Jepson R, Niven A
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40551143 · Full text
BACKGROUND: Covid-19 accelerated a transformational change in working practices, with a considerable proportion of desk-based workers now engaged in home or hybrid working. Working at home appears to exacerbate the alrea...
BACKGROUND: Covid-19 accelerated a transformational change in working practices, with a considerable proportion of desk-based workers now engaged in home or hybrid working. Working at home appears to exacerbate the already elevated levels of unhealthy occupational sedentary behaviour, and there is a need to support employees to reduce sedentary behaviour while working at home. The aim of this study was to develop an intervention to support employees to reduce sedentary behaviour when working at home utilising the novel integration of the Six Steps in Quality Intervention Development (6SQuID) and Behaviour Change Wheel (BCW) intervention development frameworks. METHODS: We report on 6SQuID steps 1-5, with the Capability, Opportunity and Motivation influence on Behaviour (COM-B) model integrated into steps 1-4, providing a theoretical organising framework. In step 4, the intervention functions and behaviour change technique elements of the BCW were used to accurately and consistently specify the active ingredients of the intervention. The test and refine phase of 6SQuID (step 5) evaluated the acceptability of elements of the intervention with a sample of Scottish Government employees. RESULTS: The causal factors for employee sedentary behaviour while working at home were delineated, and theory of change/action models were constructed. Intervention components were developed to address causal factors and presented as a toolkit on an online platform. These comprised: 1) education on sedentary behaviour, 2) resources to aid intention formation and action planning, 3) strategies to increase movement, and 4) suggestions for support from colleagues/friends/family. Strategies aimed at line managers and organisations to support employees and create an organisational culture that enables employees to move more were also developed. The acceptability testing demonstrated the value of the toolkit format incorporating a suite of strategies, and feedback informed refinement of the toolkit. CONCLUSIONS: This study addresses the urgent need to support employees to reduce sedentary behaviour while working at home. Using the novel application of integrated intervention development frameworks, a comprehensive intervention toolkit has been formulated and preliminarily tested. The toolkit comprises strategies and resources for employees, line managers and organisations. Further feasibility and effectiveness testing with a larger sample is recommended prior to large-scale implementation.
Enablers and barriers to physical activity among older adults of low socio-economic status: a systematic review of qualitative literature.
Malkowski OS, Harvey J, Townsend NP … +3 more , Kelson MJ, Foster CEM, Western MJ
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40545546 · Full text
BACKGROUND: Understanding the factors influencing physical activity in older adults, and whether they vary according to socio-economic status (SES), could help to inform interventions that are effective in reducing inequ...
BACKGROUND: Understanding the factors influencing physical activity in older adults, and whether they vary according to socio-economic status (SES), could help to inform interventions that are effective in reducing inequalities and improving the quality of life of an ageing population. This systematic review aimed to synthesise the qualitative evidence on the modifiable enablers of, and barriers to, physical activity based on low-SES older adults' perspectives in the United Kingdom (UK). A secondary aim was to identify and summarise differences in physical activity enablers and barriers between older adults of low and high SES. METHODS: We searched five electronic databases from inception to December 2023 for studies conducted among UK-based, community-dwelling older adults aged 60+ years including qualitative methods, with results reported by SES. We excluded hospitalised or institutionalised participants. Risk of bias was assessed with the Mixed Methods Appraisal Tool, and framework synthesis was applied using the Capability, Opportunity, Motivation, and Behaviour (COM-B) model. RESULTS: Thirty studies were included in the review, of which five specifically examined inequalities in physical activity enablers and barriers. Low-SES older adults' physical capability was influenced by fitness, mobility, and general health, while their psychological capability was shaped by knowledge and behavioural regulation. Physical opportunity was characterised by safety, pedestrian infrastructure, access to physical activity opportunities and daily destinations, environmental quality, and aesthetics. Themes under social opportunity encompassed social support, social norms, social engagement, and dog ownership. Physical activity was motivated by reflective processes, such as outcome expectancies, self-efficacy, and attitudes, as well as automatic processes, including habits, lack of time, and enjoyment. Few studies investigated differences between participants of low and high SES, with those that did predominantly pointing to disparities in the physical or built environment. CONCLUSIONS: This meta-synthesis of qualitative literature identified a wide range of interacting factors influencing physical activity across socio-ecological and COM-B domains, underscoring whole-system interventions as a potential approach to stimulate meaningful and sustained change. Future research could report results by SES to enhance our understanding of inequalities and ensure that low-SES older adults are represented in the development and evaluation of interventions targeting improvements in physical activity.
Correlates and determinants of physical activity among older adults of lower versus higher socio-economic status: a systematic review and meta-analysis.
Malkowski OS, Harvey J, Townsend NP … +4 more , Kelson MJ, Foster CEM, Western MJ, Physical Activity Inequalities in Later Life consortium
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40545526 · Full text
BACKGROUND: Understanding socio-economic differences in the factors influencing physical activity among older adults is essential for developing comprehensive interventions. We aimed to quantify the associations of modif...
BACKGROUND: Understanding socio-economic differences in the factors influencing physical activity among older adults is essential for developing comprehensive interventions. We aimed to quantify the associations of modifiable correlates and determinants on physical activity among older adults of lower versus higher socio-economic status in the United Kingdom. METHODS: In this systematic review and meta-analysis, we searched MEDLINE, Embase, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus from inception to December 2023, for peer-reviewed studies published in English, investigating associations between a modifiable factor as an independent variable and physical activity as a dependent variable, by socio-economic status (defined according to various area- and individual-level indicators, including neighbourhood deprivation, wealth or income, education, and occupational class), in samples of community-dwelling older adults aged 60+ years in the United Kingdom. Hospitalised and institutionalised populations were excluded. Random effects meta-analyses were performed separately for people of lower and higher socio-economic status. Risk of bias was assessed with the Mixed Methods Appraisal Tool. This study was registered with the International prospective register of systematic reviews (PROSPERO; CRD42022351708). RESULTS: Searches identified 11,472 references; seventy-seven studies met the selection criteria, of which fifty-one contributed to meta-analyses (N range = 134-29,280). Of the exposures positively associated with physical activity, physical function, social participation, and perception of general health had the largest effect sizes (standardised mean difference [SMD] range = 0.53-0.81; I range = 54.81-91.00%). Estimates were comparable among older adults of lower and higher socio-economic status, except for the presence of built physical activity facilities, access to walking and cycling infrastructure, and less smoking, which were positively associated with physical activity only among individuals of lower socio-economic status. CONCLUSIONS: Our results suggest researchers need to better understand discrepancies in the prevalence of the assessed correlates (e.g., fewer participants of lower socio-economic status reported good physical function) to inform policies that reduce inequalities in older adults' physical activity levels. However, most studies were cross-sectional. Future longitudinal and experimental research should gauge the suitability of these correlates as intervention targets.
Urban cycling-specific active transportation behaviour is sensitive to the fresh start effect: triangulating observational evidence from real world data.
Fast I, Sobhan S, Klaprat N … +5 more , George T, Vik N, Prowse D, Collett J, McGavock J
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40537806 · Full text
BACKGROUND: This study determined if cycling-specific active transportation (AT) was sensitive to the behavioural economics heuristic “The Fresh Start Effect”, with the beginning of a work week being temporal landmark fo...
BACKGROUND: This study determined if cycling-specific active transportation (AT) was sensitive to the behavioural economics heuristic “The Fresh Start Effect”, with the beginning of a work week being temporal landmark for cycling to work. METHODS: We triangulated data from five sources to test the study hypothesis. First, publicly available cycling traffic data collected from May to September between 2014 and 2019 using electromagnetic counters (EcoCounter Inc, Montreal Qc.) were used to categorize 5 urban trails as “AT” or “leisure” based on hourly cycling traffic patterns. Linear regression model with repeated measures, compared daily trends in cycling traffic over the course of a work week along the different trail types and then compared with daily trends in occupational bicycle parking (n = 56,307 counts), vehicular traffic (n = 6.2 M counts), and sales from a local coffee shop (n = 166,753 counts) over the same time frame. Effect sizes were compared to daily trends in fitness centre attendance (n = 563,290 counts), a positive control for the Fresh Start Effect. RESULTS: We found a significant ~ 22% decline in daily cycling traffic on both AT (-147 cyclists/day; 95% CI: -199.0 to -95 cyclists/day) and leisure trails (-22 cyclists/day; 95% CI: -59 to + 15 cyclists/day) over the course of a work week. The relative decline over the work week in AT-based cycling traffic was similar to the decline in daily parking (~ 14%; -12 cyclists/day; 95% CI: -17 to -7 cyclists/day). The relative effect size of this trend was nearly identical to the decline in fitness centre attendance over the work week (~ 21%; -592 visits/day; 95% CI: -759 visits/day to -425 visits/day), replicating the original Fresh Start Effect. In contrast to the decline in AT-based cycling traffic, daily vehicular traffic (+ 2248 cars/day; 95% CI: 2022 to + 3674 cars/day) and coffee sales (+ 31 units/day; 95% CI: +22 to + 42 units/day) increased ~ 7% from the beginning to the end of a work week. CONCLUSIONS: The weekly patterns of AT-based cycling are sensitive to the Fresh Start Effect. This observation could be used to inform policies for increasing cycling rates in urban centres.
The socioecological model levels, behavior change mechanisms, and behavior change techniques to improve accelerometer-measured physical activity among Hispanic women: a systematic review.
Lorenzo E, Page J, Wong R … +1 more , Lyons E
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40537788 · Full text
BACKGROUND: Interventions to increase and maintain Hispanic women's moderate-to-vigorous physical activity (MVPA) are lacking. Socioecological models hypothesize that MVPA participation is influenced by factors at multip...
BACKGROUND: Interventions to increase and maintain Hispanic women's moderate-to-vigorous physical activity (MVPA) are lacking. Socioecological models hypothesize that MVPA participation is influenced by factors at multiple levels of the environment (i.e., intrapersonal, interpersonal, organizational, neighborhood, policy). These factors, including behavior change mechanisms (BCM), are targeted with behavior change techniques (BCT) delivered through interventions to improve MVPA participation. However, the specific factors and BCT that positively influence Hispanic women's MVPA remain unknown. PURPOSE: Synthesize existing literature to determine the socioecological model levels, BCM, and BCT that significantly increased Hispanic women's accelerometer-measured MVPA. METHODS: Databases (PubMed, CINAHL, Scopus, Cochrane Library and PsychINFO) were searched using key terms ((Hispanic women) OR (Hispanic OR Mexican American OR Latina OR Latinx) AND (female) AND (exercise OR physical activity)) without date or geographic limitations in March 2023. Peer-reviewed studies published in English that tested interventions to increase Hispanic women's accelerometer-measured MVPA were included. Two authors extracted data, a narrative synthesis was conducted, and a conceptual model of a multilevel MVPA intervention was proposed. RESULTS: Nine unique interventions were identified with four studies providing additional findings (N = 13). Studies were conducted in the United States and totaled 2,303 Hispanic women (M = 28.4-44.6 years). Self-efficacy (intrapersonal level) and family participation (interpersonal level) were the only BCM that mediated MVPA post-intervention. Half of the studies targeting the organizational (n = 3/6) and 83.3% (n = 5/6) targeting the neighborhood levels demonstrated significant improvements in MVPA. BCT targeting confidence, goals, and problem-solving at the intrapersonal level, partner support and childcare barriers at the interpersonal level, and physical activity access with methods to overcome weather and safety barriers at the neighborhood level significantly improved MVPA post-intervention. None of the interventions tested for longer-term (i.e., > 9-months post-intervention) MVPA change. CONCLUSIONS: Interventions to increase Hispanic women's accelerometer-measured MVPA in the shorter-term should be developed to include BCT to increase self-efficacy (intrapersonal level) and family participation (interpersonal level) and identify physical activity opportunities/access (neighborhood level), including BCT to overcome safety and weather barriers. Future research is needed to confirm these findings and determine the socioecological levels, BCM, and BCT to maintain Hispanic women's MVPA in the longer term. TRIAL REGISTRATION: The 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was followed for this systematic review. The protocol for this systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42021285063.
Evaluating the contribution of a scaled up community-based overweight prevention programme in the Netherlands to children's health behaviours and BMIz.
Huiberts I, Motazedi E, Mölenberg FJM … +4 more , Singh AS, Collard D, ChinAPaw MJM, van Lenthe FJ
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40533781 · Full text
BACKGROUND: Community-based overweight prevention programmes are widely implemented, however, little is known about their effectiveness after scale-up. This study examines the contribution of a scaled up community-based...
BACKGROUND: Community-based overweight prevention programmes are widely implemented, however, little is known about their effectiveness after scale-up. This study examines the contribution of a scaled up community-based overweight prevention programme in the Netherlands: Healthy Youth, Healthy Future (JOGG) to children's BMIz, adherence to fruit and/or vegetable consumption guidelines, and minutes of moderate to vigorous physical activity (MVPA) per week. METHODS: In this observational study we used repeated cross-sectional data from 5 to 11- and 12-18-year-old participants in the annual Dutch national health survey (2006-2019) and applied two analytical methods for more robust inference. First, we applied linear mixed models to assess the association between JOGG exposure for at least 18 months (n = 1,008) vs. no exposure (n = 23,779) and the outcomes and assessed whether this association differed across subgroups defined by age, socioeconomic position (SEP), or migration background. Second, we compared outcome trends in JOGG and non-JOGG municipalities before and after implementation, using a difference-in-differences approach, to account for unobserved time-invariant confounders. RESULTS: Results showed no significant association between JOGG exposure and BMIz or MVPA. However, JOGG exposure was associated with higher adherence to fruit and/or vegetable consumption guidelines in 12- to 18-year-olds (log odds 1.82, 95%CI 0.23, 3.41). We observed no differential associations across subgroups and no differences in outcome trends between JOGG and non-JOGG municipalities. CONCLUSIONS: The scale up of JOGG in the Netherlands between 2010 and 2019 potentially contributed to higher fruit and vegetable consumption but not to BMIz or MVPA levels. Further examination of the implementation process may provide insight in underlying mechanisms and contribution of JOGG.
Six-month intervention effect of a digital movement behavior intervention on parent- and child intermediary outcomes-results from the Let's Grow randomized controlled trial.
Sandborg J, Downing KL, Orellana L … +4 more , Taylor RW, Barnett LM, Carson V, Hesketh KD
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40524171 · Full text
BACKGROUND: Parental-focused interventions often aim to improve child health behaviors by changing parenting practices and cognitions and supporting child skill development. These intermediary outcomes serve as milestone...
BACKGROUND: Parental-focused interventions often aim to improve child health behaviors by changing parenting practices and cognitions and supporting child skill development. These intermediary outcomes serve as milestones that indicate progress towards achieving the ultimate intervention goal; however, the impact on these is rarely reported. The aim of this study was to investigate the effect of a digital intervention, intended to help parents promote healthy movement behaviors in toddlers on these intermediary outcomes. METHODS: This study utilized data from the Let's Grow trial (n = 1165). Participants were recruited Australia-wide and randomized to usual care (routine child healthcare visits) or intervention (usual care plus Let's Grow app) following baseline assessment. Participants with data on at least one intermediary outcome (assessed via an online survey) at baseline and mid-intervention (6-months) were included (usual care, n = 618; intervention, n = 547). These included parental cognitions (knowledge, self-efficacy, confidence) and behaviors (co-participation, role modelling, family rules and routines, screens in child's bedroom), and child developmental skills (motor skills, emotional regulation). Linear regression compared between-group outcomes. We also explored whether changes in the intermediary outcomes were associated with intervention engagement (Web app analytics). RESULTS: The intervention group had higher knowledge of child movement behaviors (mean difference = 0.41, P = 0.002) compared to control. This difference was driven by knowledge in physical activity (mean differences 0.12, P = 0.028) and sleep (mean difference 0.27, P = 0.003) topics. No significant effect was observed for the other intermediary outcomes. Higher engagement was associated with improvements in parental knowledge of child movement behaviors and physical activity, confidence, ease of parenting, family rules for movement behaviors and screen time, and less parental screen time (all P ≤ 0.039). CONCLUSIONS: While Let's Grow positively influenced physical activity and sleep knowledge at the mid-intervention point, our findings suggests that parents might need more time or support to improve cognitions and behaviors related to children's sedentary behavior/screen time and child developmental skills. Further clarity on whether the observed changes translate into differential impacts on child movement behaviors will be reported following trial conclusion. Engagement appears to enhance intervention effects, highlighting the importance of strategies to optimize engagement. TRIAL REGISTRATION: ACTRN12620001280998; U1111-1252-0599.
The effect of computer prompt in breaks of sedentary behaviour among office workers: a systematic review and meta-analysis.
Leppe-Zamora J, Ramos-Fuster S, Muñoz-Monari B … +2 more , Roa-Alcaino S, Sarmiento OL
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40514667 · Full text
BACKGROUND: Prolonged sitting time in the workplace constitutes a significant portion of waking hours. Sedentary behaviour is associated with higher risks of cardiovascular diseases, obesity, and all-cause mortality. Int...
BACKGROUND: Prolonged sitting time in the workplace constitutes a significant portion of waking hours. Sedentary behaviour is associated with higher risks of cardiovascular diseases, obesity, and all-cause mortality. Interventions to reduce workplace sitting, such as health apps, height-adjustable desks, and active breaks, have shown relative effectiveness in improving health outcomes. Among these, computer prompt interventions represent a simple and scalable strategy that can remind workers to take breaks and reduce sedentary behaviour. This study evaluates the effectiveness of computer prompt interventions to reduce sitting at work compared to no intervention or combined strategies. METHODS: Primary studies were searched in PubMed (MEDLINE), EMBASE, Scopus, and CENTRAL of the Cochrane Library. The search was conducted until December 2024. Keywords included terms like "sedentary behaviour," "computer prompts," "sitting time," and "office workers." Only randomized controlled trials (individual or cluster) involving desk-based workers aged 18 or older that evaluated computer prompt software were included. Risk of bias was assessed using the Cochrane Risk-of-Bias tool (RoB2). Mean differences with 95% confidence intervals (CI) were calculated for sitting time and secondary outcomes. Analyses were performed using RevMan and R software, and GRADE methodology was applied to assess the certainty of evidence. RESULTS: From 17,880 records, 18 studies involving 1164 office workers were included in the analysis. Ten studies focused exclusively on computer prompts, while 8 studies implemented combined strategies (e.g., computer prompts plus sit-to-stand desks). The median intervention length was 8 weeks, ranging from one to 24 weeks. Studies using only computer prompts included breaks lasting from 1 to 10 min every 30 min up to an hour. Combined strategies included breaks from 6 to 30 min every 30 min up to 3 h. According to objective measurements, the meta-analysis showed a significant reduction of 12.46 min/workday in sitting time (95% CI: -18.12, -6.80) and a significant increase of 1029.99 steps/workday (95% CI: 815.97, 1244). Secondary outcomes included work-related, musculoskeletal, and cardiometabolic outcomes favouring computer prompts but not statistically significant. The certainty of evidence for primary outcomes is rated low to moderate according to GRADE. CONCLUSIONS: Computer prompt software interventions show effectiveness in reducing sitting time among office workers. However, more long-term prospective studies with larger sample sizes are needed to accurately determine the effectiveness of computer prompts on various work- and health-related outcomes. TRIAL REGISTRATION: The review protocol was registered in the Prospero database (CRD42021287870).
Dietary consumption trajectory profiles over time of French adults from the NutriNet-Santé cohort (2014-2022): multicriteria analysis of sustainability.
Toujgani H, Wang J, Perraud E … +12 more , Baudry J, Berlivet J, Allès B, Fouillet H, Hercberg S, Touvier M, Lairon D, Pointereau P, Couturier C, Mariotti F, Kesse-Guyot E, TRANSFood Consortium
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40514663 · Full text
BACKGROUND: Dietary patterns significantly impact climate change and morbidity, making transitions to sustainable diets urgent. Few studies explore repeated dietary measures collected over several years or variations acr...
BACKGROUND: Dietary patterns significantly impact climate change and morbidity, making transitions to sustainable diets urgent. Few studies explore repeated dietary measures collected over several years or variations across distinct consumer profiles characterized by sociodemographic and dietary patterns. OBJECTIVE: Our study aims to identify dietary trajectory profiles in French adults (2014-2022), assessing environmental, nutritional, and health outcomes. METHODS: Consumption data from 17,187 NutriNet-Santé cohort participants (52% women, average age 48y, SD = 16) were collected via food frequency questionnaires in 2014 (weighted to the French Census), 2018, and 2022. Dietary trajectory profiles were modeled using Group-based multi-trajectory modeling based on principal component analysis of energy-adjusted consumption data. Associations with environmental (greenhouse gas (GHG) emissions) and nutritional (adherence to French dietary guidelines, diet quality index) dimensions were assessed via multivariable mixed models. Health impacts were evaluated as Disability-Adjusted Life Years (DALYs)avoided, using the Comparative Risk Assessment approach. RESULTS: Six dietary trajectory profiles (P) with distinct starting diets and evolutions were identified. P0 had average intakes, while P1 and P5 were meat-focused, with P5 showing the highest animal consumption. P3 and P4 leaned plant-based, with P4 maintaining high fish and plant intakes, and P3 increasing ruminant meat. P2 initially high in salty or sweet fatty foods, shifted significantly toward plant-based diets. Over time, GHG emissions decreased (- 5% to - 14%), diet quality (PNNS-GS2 score) improved (+ 12% to + 174%), and health risks declined in four profiles due to reduced red meat and higher whole grains/fruits but increased for P4 and P5 due to processed meat. CONCLUSION: These profiles reflect diverse population segments with distinct dietary profiles and degrees of sustainability improvements. However, significant advancements remain limited, highlighting the need for further research on economic, psychological, and cultural factors to guide sustainable changes. TRIAL REGISTRATION: Trial registration number: NCT03335644. URL of registration: https://clinicaltrials.gov/study/NCT03335644?id=NCT03335644&rank=1.
StandUPTV: a full-factorial optimization trial to reduce sedentary screen time among adults.
Keadle SK, Hasanaj K, Leonard KS … +11 more , Fernandez A, Freid L, Weiss S, Legato M, Anand H, Hagobian TA, Phillips SM, Phelan S, Guastaferro K, Seltzer RGN, Buman MP
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40514642 · Full text
BACKGROUND: Using the multiphase optimization strategy (MOST) framework, we aimed to identify an optimized mHealth-delivered intervention for reducing recreational sedentary screen time (rSST) by at least 60 min/day amon...
BACKGROUND: Using the multiphase optimization strategy (MOST) framework, we aimed to identify an optimized mHealth-delivered intervention for reducing recreational sedentary screen time (rSST) by at least 60 min/day among adults. METHODS: Eligible participants were 23-64 years old and self-reported elevated rSST (> 3 h/day). Following a 7-day baseline, participants received a core mHealth application (self-monitoring and 50% reduction target and educational materials) and were randomly assigned to three additional components set to on/off in a full-factorial (2) experiment: LOCKOUT: rSST electronically restricted; TEXT: rSST reduction prompts; and EARN: rSST through physical activity. rSST was assessed at baseline and 16 weeks via an integrated measure that included objectively assessed sedentary time (activPAL accelerometer) and screen time (TV Wifi plugs and tablet usage). We used a linear mixed effect model to evaluate the change in rSST for the three intervention components and their interactions. RESULTS: A total of 82% of the randomized participants (N = 110) were female, with a mean ± SD age of 41 ± 11.7 y and a BMI of 29.7 ± 7.8 kg/m2, and their mean (95% CI) rSST was 184.7 (172.8, 196.5) min/day at baseline. The expected difference (baseline vs. 16 weeks) in rSST was greatest for the intervention versions with the core plus EARN on with an average reduction of -118.1 (-163.0, -73.1) min/day and for core plus LOCKOUT, TEXT, & EARN on (-125.7 [-172.0, -79.3] min/day). CONCLUSIONS: We identified several promising intervention versions that exceeded our optimization objective. This study provides important evidence on efficacious multicomponent interventions that should be moved forward to the evaluation phase of the MOST framework to test the effect of rSST reductions on health outcomes. TRIAL REGISTRATION: (clinicaltrials.gov NCT04464993).
Systems approaches in public health: beyond mapping the causes.
Crielaard L, Nicolaou M, Brown AD … +6 more , Dijkstra SC, Ter Ellen F, Elsenburg LK, Luna Pinzon A, Waterlander WE, Stronks K
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40506701 · Full text
BACKGROUND: Systems approaches are increasingly adopted in public health, commonly operationalised using system dynamics (SD). In public health, systems approaches have prioritised understanding the current system by des...
BACKGROUND: Systems approaches are increasingly adopted in public health, commonly operationalised using system dynamics (SD). In public health, systems approaches have prioritised understanding the current system by describing the causes of a complex problem - e.g. obesity - as a system. It remains challenging to advance from understanding the current system producing undesired outcomes, towards responses to improve outcomes. Rather than creating models of the (entire) system, SD traditionally emphasises specific models to support policy development. While core concepts from SD have effectively been adopted in public health, there may be more to learn from SD when it comes to designing systems approaches that can fulfil the purpose of informing problem responses. METHODS: We reviewed seminal SD literature for clues on how to refine the focus of systems approaches, so that they lead to specific models supporting policy development. We conducted a narrative review, seeking a strategy that can be leveraged in systems approaches in public health. We concentrated on SD's problem framing strategy, leading to two insights. RESULTS: Insight 1: Alongside the complex problem at stake (e.g. obesity), consider the intended result of the systems approach (coordination, learning, analysis or transformation). This helps recognise which system components are relevant to problem responses and make methodological decisions accordingly. Insight 2: If investigation of the current system reveals that only radical change can lead to improved outcomes, then proceed to envisioning how the system could be fundamentally transformed to support those desired outcomes. This next step helps to anticipate policy resistance, unintended consequences and counterintuitive behaviour by contemplating how the system would react due to proposed problem responses. CONCLUSIONS: Applying a problem framing strategy, as is commonly done in SD, could make systems approaches in public health better positioned to inform problem responses. Problem framing stimulates the contribution of systems approaches to health policy, prioritising system components relevant to problem responses (Insight 1), which may not be part of the system (Insight 2).
Daily time-use compositions of physical behaviours and its association with evaluative and experienced wellbeing: a multilevel compositional analysis.
Narayanan A, Duncan S, Smith C … +5 more , Le F, Mackay L, McPhee J, Chaix B, Stewart T
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40500771 · Full text
BACKGROUND: The composition of daily time-use physical behaviours-such as sedentary behaviour (SB), light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and sleep may be crucial for overall healt...
BACKGROUND: The composition of daily time-use physical behaviours-such as sedentary behaviour (SB), light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and sleep may be crucial for overall health and wellbeing. This study examined the associations between these time-use behaviours and both evaluative wellbeing (life satisfaction) and experienced wellbeing (momentary happiness, anxiousness, and tiredness). Evaluative wellbeing reflects an individual's overall life assessment, while experienced wellbeing captures real-time affective states. We investigated these associations by reallocating time among behaviours and assessing the predicted impact on wellbeing outcomes. METHODS: Time-use behaviours were obtained from 211 adults who wore Axivity AX3 accelerometers on their wrists for seven days. Participants also completed a survey to assess demographics and life satisfaction, before using a custom smartphone app to report their real-time happiness, anxiousness, and tiredness levels over seven days (at three random times each day). Time-use data were processed using UK Biobank machine learning algorithms. We employed Bayesian multilevel compositional analysis to investigate how time-use behaviours, and reallocating time between behaviours, were associated with both life satisfaction and momentary affective states. RESULTS: Increasing sedentary time (relative to other behaviours) over the week of observation was negatively associated with happiness and positively associated with anxiousness aggregated at the day level. Conversely, increasing the proportion of MVPA (relative to other behaviours) was associated with reduced anxiousness and tiredness. Substitution analysis showed that reallocating 20 min of SB to MVPA increased happiness by 0.12 units, 95% CI [0.01, 0.22] and reduced anxiousness by 0.20 units, 95% CI [-0.34, -0.07]. Additionally, reallocating 20 min of time spent in LPA to MVPA reduced tiredness by 0.16 units, 95% CI [-0.28, -0.03]. All affective states are reported on a 0-10 scale. No associations were found between time-use behaviours and life satisfaction. CONCLUSION: Our study shows that time-use behaviours, particularly reducing sedentary time and increasing physical activity, were more strongly linked to experienced wellbeing. Studies that focus solely on examining time-use behaviours and long-term wellbeing outcomes, such as life satisfaction (common in population studies), may overlook the dynamic interplay and immediate impacts of behaviours on wellbeing. While some associations were present, most of the tested relationships were weak or non-significant, suggesting that contextual factors like social and environmental conditions may play a greater role in shaping wellbeing. The next step is to explore sequential associations, such as behaviours occurring immediately before or after a momentary affect response is recorded.
Cycling infrastructure as a determinant of cycling for recreation and transportation in Montréal, Canada: a natural experiment using the longitudinal national population health survey.
Prince SA, Thomas T, Apparicio P … +5 more , Rodrigue L, Jobson C, Walker KL, Butler GP, Wasfi R
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40495159 · Full text
BACKGROUND: Cycling is associated with numerous health benefits. Evidence suggests that new cycling infrastructure leads to increases in cycling, though studies of network-level changes are lacking. The objective of this...
BACKGROUND: Cycling is associated with numerous health benefits. Evidence suggests that new cycling infrastructure leads to increases in cycling, though studies of network-level changes are lacking. The objective of this study was to determine the longitudinal effect of cycling infrastructure on cycling engagement among adults living in Montréal, Canada. METHODS: Using data from the National Population Health Survey (1994-2011), this study included adults who resided in the Montréal Census Metropolitan Area for a minimum of two survey cycles (N = 779). Outcomes included self-reported any cycling (transportation or recreation) and time in recreational cycling (minutes/week). Archival maps describing temporal changes in the cycling network for five-year intervals (1991-2011) were classified using the Canadian Bikeway Comfort and Safety Classification System (Can-BICS). Three cycling exposures were calculated from the centroid of each dissemination area: (1) distance to the nearest cycling path categorized by Can-BICS comfort-level (low, medium or high), (2) presence of cycle paths of each comfort level within distance thresholds (low = 321 m, medium = 623 m, high = 1790 m), and (3) density of cycle paths within a 1000 m buffer. Mixed effects logistic regression models estimated associations between cycling infrastructure and any cycling. Linear mixed effects models estimated associations between cycling infrastructure and time spent in recreational cycling. RESULTS: Over the study period, low- and medium-comfort cycle paths were more prevalent than high-comfort paths and cycling for recreation was more common than cycling for transportation. Exposure to high-comfort paths within an acceptable distance (< 1790 m) was associated with higher odds of any cycling (aOR = 1.28, 95% CI: 1.00-1.63). Cumulative exposure to medium-comfort paths within an acceptable distance (< 623 m) was associated with greater time spent in recreational cycling (β = 0.09, 95% CI: 0.03-0.16). Gender-stratified analyses suggested that cumulative exposures to low- and medium-comfort infrastructure within distance thresholds was associated with time spent in recreational cycling (low: β = 0.06, 95% CI: 0.00-0.12, medium: β = 0.13, 95% CI: 0.04-0.22,) among women. No significant effects were observed for distance to the nearest cycling infrastructure for either outcome. Density was not examined in models due to low variation with most buffers having no cycling infrastructure. CONCLUSIONS: This research provides evidence that cycle paths, especially of higher comfort and safety, can promote cycling. Future work is needed to explore cumulative exposures to cycling infrastructure, taking into consideration connectivity of networks, integrated public transport, and accessibility to work.
Physical activity promotion in physical therapy, exercise therapy and other movement-based therapies: a scoping review and content analysis of intervention studies and theoretical works.
Matting L, Pfeifer K, Sudeck G … +3 more , Jung A, Langhirt F, Geidl W
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40495142 · Full text
BACKGROUND: Movement-based therapists, including physical, exercise, and sport therapists, play a key role in promoting physical activity in individuals with non-communicable diseases. However, no clear consensus exists...
BACKGROUND: Movement-based therapists, including physical, exercise, and sport therapists, play a key role in promoting physical activity in individuals with non-communicable diseases. However, no clear consensus exists on effective intervention approaches. This scoping review examines available intervention studies and theoretical works for physical activity promotion in movement-based therapy. METHODS: In accordance with Colquhoun et al.‘s framework and PRISMA-ScR guidelines, we systematically searched PubMed, Scopus, Web of Science, and PsycINFO until March 31, 2024. Eligible records described physical activity-promoting concepts including interventional studies and theoretical works applicable in movement-based therapies for individuals with non-communicable diseases. Data extraction covered assessment, therapeutic content, didactic-methodological principles, and theoretical underpinnings. Interventions were categorized based on behavior change techniques (BCTs), the behavior change wheel, and a clinical reasoning model for clients behavior change. Network analysis explored relationships between therapeutic content and didactic-methodological principles. RESULTS: Fifty-seven records met inclusion criteria; 77% were intervention studies, and 23% were theoretical works. Most concepts originated from orthopedics/rheumatology (23%), neurology (21%), and oncology (9%), while 12% were generic concepts. Across concepts, 66 biopsychosocial assessment instruments and 60 BCTs were applied (Median BCTs per concept: 11.5, range: 4–37). Key didactic-methodological principles included tailoring/individualization (n = 47), active participation (n = 39), collaborative communication (n = 21), and patient self-responsibility and independence (n = 14). Least mentioned was facilitating positive movement experiences and enjoyment of physical activity (n = 3). Network analysis identified action planning, goal setting, and feedback as central BCTs. CONCLUSION: This review provides an overview of 57 physical activity promotion concepts used in movement-based therapies for individuals with non-communicable diseases. Findings reveal considerable heterogeneity, highlighting diverse strategies used by movement-based therapists to influence physical activity behavior. TRIAL REGISTRATION: Open Science Framework (OSF), December 23, 2022 (DOI: https://doi.org/10.17605/OSF.IO/AXZSJ ).
Associations between parental perceptions of neighbourhood environment and physical activity in children and adolescents: a systematic review including 149 studies.
Xing R, Rachele JN, Matolic T … +5 more , Loh V, Cerin E, Jiao J, Huang WY, Pedisic Z
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40481465 · Full text
BACKGROUND: Parental perceptions of the neighbourhood environment can be of particular importance for physical activity of children and adolescents, because parents act as the gatekeepers of their children's behaviour. H...
BACKGROUND: Parental perceptions of the neighbourhood environment can be of particular importance for physical activity of children and adolescents, because parents act as the gatekeepers of their children's behaviour. However, knowledge gaps remain regarding the associations between parental perceptions of neighbourhood environment and physical activity among children and adolescents. Therefore, the aim of this study was to systematically review and summarise evidence on the association between parental perceptions of the neighbourhood environment and physical activity among children and adolescents (5 - 17 years of age). METHODS: Literature searches were conducted in: CINAHL, Embase, Environmental Science, MEDLINE/PubMed, PsycInfo, Scopus, SPORTDiscus, Transportation Research Information Services, and Web of Science. The associations were coded as: mostly favourable (for 60% - 100% of studies showing a positive association); mostly unfavourable (for 60% - 100% of studies showing a negative association); and mostly non-significant, indeterminate, or inconsistent. RESULTS: Out of 30,162 records identified in the search, 162 papers from 149 studies were included in the review. The most consistent finding was that a greater distance to school is unfavourably associated with active travel. Evidence of this association was found in children (5/7 associations; pooled sample size in the studies showing significant association [n] = 14,113), adolescents (3/4; n = 2328), and mixed-age group (8/13; n = 5410). There was some consistency in evidence on favourable associations of: (1) access to public transport, good street lighting, and presence of crossing guards with active travel among children; (2) access to sports and recreational facilities, parks and/or playgrounds with sports participation among children; and (3) access to sports and recreational facilities, parks, and/or playgrounds with non-type-specific physical activity among adolescents. Several associations were found in individual studies only, while others were mostly non-significant, indeterminate, or inconsistent. The quality of evidence ranged from very low to low. CONCLUSIONS: Parental perceptions of traffic safety and access to destinations and services are associated with different types of physical activity among children and adolescents. There is a need for longitudinal and experimental studies, more research among adolescents, more studies from low- and middle-income countries, and exploring a wider range of neighbourhood environment attributes.
Correction: Maintenance effects of a multilevel workplace intervention to reduce sedentary time: twenty-four-month follow-up of the group randomized clinical trial 'stand and move at work'.
Leonard KS, Larouche M, Mitchell NR … +7 more , Rydell SA, Toledo MJ, Mullane SL, Hasanaj K, de Brito JN, Buman MP, Pereira MA
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40457461 · Full text
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Multisession transcranial direct current stimulation and aerobic exercise synergistically improve food craving symptoms, impulsivity, and cognitive flexibility in women with overweight and obesity: a randomized controlled trial.
Khataei SM, Amiri E, Machado DGDS
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40457443 · Full text
BACKGROUND: We explored the potential synergistic effects of combining multisession anodal transcranial direct current stimulation (a-tDCS) with chronic aerobic exercise (AE) on food cravings (FC), impulsivity (IMP), ris...
BACKGROUND: We explored the potential synergistic effects of combining multisession anodal transcranial direct current stimulation (a-tDCS) with chronic aerobic exercise (AE) on food cravings (FC), impulsivity (IMP), risky decision-making (RDM), and cognitive flexibility (CF) in women with overweight or obesity exhibiting food craving symptoms. METHODS: Thirty-six women with overweight or obesity and symptoms of food craving (age: 26±6,4 years) were randomly allocated into three groups using permuted block randomization (n = 12 each): (1) a-tDCS + AE, (2) Sham + AE, and (3) Control (no intervention). During Phase 1, the a-tDCS + AE group received five consecutive sessions of a-tDCS, while the Sham + AE group received sham tDCS. In Phase 2, both the a-tDCS + AE and Sham + AE groups completed three sessions of moderate-intensity continuous aerobic exercise per week for four weeks. Outcome measures, including food cravings (FC) and cognitive flexibility (CF), were assessed at baseline, after five days of tDCS, and after four weeks of AE. Follow-up measurements for FC and CF were also conducted one month post-intervention. RESULTS: FC was lower in the a-tDCS + AE group compared to Sham + AE and Control groups in Phase 1 (Cohen’s d = 1.4 and 1.9, respectively). In Phase 2, a-tDCS + AE and Sham + AE groups showed lower FC than the Control group (d = 3.8 and d = 2.8, respectively), and a-tDCS + AE also showed a lower FC compared to the Sham + AE group (d = 1.5). FC remained lower in the a-tDCS + AE group compared to Sham + AE and Control groups at follow-up (d = 1.7 and d = 2.4, respectively). CF was higher in the a-tDCS + AE compared to Sham + AE and Control groups (d = 2.1 and d = 1.4, respectively) and in the sham + AE (d = 1.0) compared to control in Phase 2. At follow-up, CF was higher only in the a-tDCS + AE group compared to the Control (d = 1.2). IMP scores were higher in the a-tDCS + AE group compared to the other groups in Phases 1 (d = 1.0 and d = 1.4) and 2 (d = 5.4 and d = 1.9). RDM was higher in the a-tDCS + AE compared to the Control group in phase 2 (d = 1.3). CONCLUSIONS: Multisession a-tDCS combined with four weeks of moderate AE synergistically reduces food cravings and improves related variables to a greater extent than AE alone, with sustained effects, in women with overweight or obesity and symptoms of food craving. TRIAL REGISTRATION: This study was registered in the Iranian Registry of Clinical Trials (IRCT id: IRCT20210617051606N7; Registration date: 04.02.2023).
Correction: Differences in elementary-age children's accelerometer - measured physical activity between school and summer: three-year findings from the What's UP (Undermining Prevention) with summer observational cohort study.
Beets MW, Burkart S, Pfledderer C … +12 more , Adams E, Weaver RG, Armstrong B, Brazendale K, Zhu X, McLain A, Turner-McGrievy B, Pate R, Kaczynski A, Fairchild A, Saelens B, Parker H
Int J Behav Nutr Phys Act · 2025 Jun · PMID 40457323 · Full text
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Population level effects of the active kids program on children and adolescents' physical activity and sport participation in NSW, Australia.
Owen KB, Foley BC, Reece LJ … +2 more , Bellew W, Bauman A
Int J Behav Nutr Phys Act · 2025 May · PMID 40437604 · Full text
BACKGROUND: Active Kids was a universal program that aimed to reduce the cost of sport and active recreation programs for all school-enrolled children and adolescents (4.5-18 years) in New South Wales (NSW), Australia th...
BACKGROUND: Active Kids was a universal program that aimed to reduce the cost of sport and active recreation programs for all school-enrolled children and adolescents (4.5-18 years) in New South Wales (NSW), Australia through provision of $100 vouchers. This study assesses trends in physical activity and sport participation in children and adolescents in NSW during its implementation to determine population level program effects. METHODS: This study used the Active Kids program data from January 31 2018 to December 31 2022. Children and adolescents who registered in the program provided physical activity and sport participation data each year. The NSW Population Health Survey (PHS) and NSW AusPlay data measured the same outcomes from 2017 to 2022 in representative samples of the population. We calculated weighted prevalence estimates for physical activity and sport participation each year, and by age, gender, and socioeconomic status. RESULTS: In the five-years of Active Kids program implementation, there was a slight decrease in the proportion of children and adolescents meeting physical activity guidelines (2018: 19.3%, 95% CI 19.2-19.4; 2022: 16.1%, 95% CI 16.0-16.2). In PHS between 2017 and 2022, there was also a slight decrease in the proportion of children and adolescents meeting physical activity guidelines (2017: 32.6%, 95% CI 29.1-36.0; 2022: 27.9%, 95% CI 24.4-31.5), with a larger drop in 2020 (24.4%, 95% CI 20.8-27.9). In the same period (2018-2022), there was a decrease in the proportion of children and adolescents who participated in sport at least once per week (2018: 70.3%, 95% CI 70.2-70.4; 2022: 53.6%, 95% CI 53.5-53.7). There was also a decrease in the proportion of children and adolescents who participated in sport at least once per week between 2017 and 2021 (2017: 78.2% 95% CI 74.5-81.9; 2021: 63.4%, 95% CI 60.1-66.8), with a slight increase in 2022 (69.8%, 95% CI 66.7-72.9). CONCLUSIONS: We found no increases in overall population levels of physical activity or sport participation among children and adolescents in NSW between 2017 and 2022. The single-component, universal program design should be modified, using targeted behaviour change theories, to address inequalities and stimulate population-level increases in physical activity and sport participation. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12618000897268).
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