Demographic Factors: Consistent PA Correlates

 Age (-)
 BMI (-)
 Blue-collar occupation (-)
 Male gender (+)
 White race (+)
 Education (+)
 Income (+)

PA & Age
 Pa declines with age in adolescents
 Especially for girls
 Shown in NHANES (accelerometer)
 PA also decreases from adulthood to other adulthood…Why?

PA & Gender
 Objective data showed boys more active than girls
 Determinant for ages 4-9
 Correlated for adolescents and adults
 At all other ages, males consistently more active than females
 Seen more vigorous than moderate intensity
 Why?
 Development of motor skills is different
 Women hang out in smaller groups and do activities that are more sedentary
 Men play sports and women work around the house
 Men have more muscle mass more energy

PA & Race/Ethnicity
 Non-Hispanic whites more active and less sedentary than non-Hispanic blacks and Hispanics
 Especially for women
 Not for children, but seen in adolescents
 less known about Native Americans and Asians/Pacific Islanders

PA & Education and Income (SES)

 Education & income are positively associated with LTPA
 Parental education + associated with PA
 Inverse relationship in adolescents
 Why?
 Higher education  stress on adolescents  behavioral concept

Biological Factors
 Health status (+)
 Those reporting better health (adults)
 Genetics/heritability (+)
 Evolution (-)
 Overweight or obesity (-)
 Not clear in youth
 Parental weight related to PA in children (-)

Psychosocial Factors in Adults

 Inverse relationship
 Barriers to exercise (including lack of time)
 Mood disturbance (stress/mental health)
 PA characteristics and perceived effort
 Positive relationship
 Self-efficacy
 Intention to exercise
 Perceived benefits
  Enjoyment
 Self-motivation
 Stage of change
 Attitude
 Knowledge

Psychosocial Factors in Adolescents

 Inverse relationship
 Barriers to PA (including lack of time)
 Depression
 Positive relationship
 Self-efficacy
 Perceived competence
 Attitude
 Self-perception (body image)
 PA intention
 Self-motivation/ Goal orientation
 Perceived behavioral control
 Value of health and status

Psychosocial Factors in Children

 Inverse relationship
 Barriers to PA
 Positive relationship
 Self-efficacy
 PA intention
 Fun/enjoyment/preference of PA

Characteristics of the Person

 Psychological, cognitive, and emotional

 Perceived barriers, mood disturbance, perceived lack of time, poor body image, attitudes, health locus of control,
knowledge, normative beliefs, stress, value of exercise outcomes, enjoyment of exercise, outcome expectancy,
intentions, perceived health or fitness, self-efficacy, self-motivation, self-schema, stage of change

 Behavioral attributes and skills

 Activity history during adulthood, dietary habits, past exercise program, processes of change, activity history during
youth, coping skills, sports media use, decision balance sheet, school sports, smoking

Behavioral Factors
 Previous PA
 For adults, adulthood PA (+)
 Children & adolescents, previous PA (+)
 Smoking – adolescents (-)
 Time outdoors – children (+)
 Participation in PE/school or community sports – adolescents (+)
 Sedentary after school/on weekend – adolescents (-)
 Healthy diet – children & adults (+)

Influencing Factors
 Past Activity Behavior
 Data on 7,794 participants
 Completed questionnaires when 14 and 31
 Frequent participation in sports after school = higher level of PA at 31
 Other Lifestyle Behaviors
 Data on 11,000 children 12-18 yrs
  Little or no PA = cigarette smoking, marijuana use, poor dietary habits, television watching, failure to wear seat
belts, perception of low academic performance

Social and Cultural Factors

 For adults: social support from friends and peers
 Even greater for women and older adults
 for children: parental PA (boys), parents and family support for PA
 for adolescents: siblings being active, general social support, parental and family support for PA, parental attitudes

Environmental Factors in Children

 Topic of increased study in last decade
 In children:
 Walkability (+)
 Traffic speed and volume (-)
 Land use mix (+)
 Residential density (+)
 Access or proximity to recreation facilities (+)
 In adolescents:
 Land-use mix (+)
 Residential density (+)

Neighborhood and Community Walkability

 Choice to walk might be shaped by
 Environmental attributes (sidewalks, shade, accessible destinations)
 Reinforcing consequences (completion of errands, socializing, use of recreational facilities)

Characteristics of the Environment

 Human environment
 Class size, exercise models, group cohesion, past family influence, SS from staff/instructor, physician influence,
social support (SS) from friends/peers, SS from spouse/family
 Physical environment
 Climate/season, cost of program, disruptions in routine, heavy traffic, high crime rates, hilly terrain, neighborhood
safety, presence of sidewalks, access to facilities (actual), access to facilities (perceived), home equipment,
enjoyable scenery, frequent observations of others exercising, adequate lighting

Social Support
 Study of 3,342 adults from 6 European countries – Social environment biggest predictor
 Companionship
 Encouragement
 Assistance or information from friends, family members, and others
 Tangible aid and service from community
 Advice, suggestions, information from professionals

PA characteristics
 Perceived exertion, intensity
 The harder it is, the less likely we are to stick with it

Chronic Disease in Children

 Childhood obesity is increasing
 2-19 years old: 5% in 1960→20% in 2016
 NOT only an American problem!!
 Childhood obesity is associated with
 Hypertension
 Abnormal lipid levels
 Type 2 diabetes in youth
 25% adolescents have prediabetes
 Incidence in type 2 diabetes is increasing by 5% every year
 Childhood cancer linked to obesity
 Majority of cases in youth continue throughout adulthood
PHYSICAL ACTIVITY AND OBESITY

What classifies a person as being overweight or obese?

 BMI

BMI- Adults
 To calculate
 Weight (kg)/ height (m2)
 Underweight
 BMI< 18.5 kg/m2
 Normal
 >18.5 and <25.0 kg/ m2
 Overweight
2
 ≥ 25.0 and < 30.0 kg/m
 Obese
2
 ≥ 30.0 kg/m
Morbid obesity = 40


BMI- Youth
 Sex- and age-specific charts
 Calculate BMI the same way you do for adults
 Plot measurements on appropriate growth chart
 Overweight: ≥ 85th to <95th percentile
 Obese: ≥ 95th percentile

What are some limitations with BMI?

 Doesn’t count for muscle mass
 Doesn’t account for distribution of body fat

 42.4% of US adults are obese

 78% of US adults are overweight or obese

Prevalence of Childhood Obesity

 18.5% of children are obese
 34.2% are overweight or obese
 Since 1980, childhood obesity rates have TRIPLED

Obesity affects some groups more than others: Income level

 Men
 Among non-Hispanic black and Mexican American men, higher income= less likely to be obese
 Women
 Higher income= less likely to be obese

Obesity affects some groups more than others: Education level

 Men
 No relationship
 Women
 Women with college degrees less likely to be obese compared with less educated women
Weight of the Nation: Challenges
 Things to note as you watch:
 Is overeating a problem with biology or psychology?
 50% bio and 50% psyc
 What do they mean by the ‘mismatch’ contributing to obesity?
 We live in an environment with excess and a lot of extra food
 What has changed in the last 30 years to cause this epidemic?
 Engineered physical activity out of our lives
 Too much screen time
 Overly stressed

What are the consequences of obesity?

Obesity Paradoxes
1. Obesity is protective in chronic disease states
2. Overweight is protective in normal populations
3. Obesity is not a risk factor for mortality in fit individuals
4. A sizeable population of obese adults has normal cardiometabolic risk profiles

Recommended Therapy for Overweight and Obesity (NHLBI)

 Goal: 5-10% weight reduction over 6 months
PHYSICAL ACTIVITY INTERVENTION: CHILDREN

Childhood Obesity
 BMI- measure of weight related to height
 Prevalence of obesity is seen in every country in all age groups US has highest prevalence
 Prevalence of obesity increases with age
 16.1% of children ages 10-17 were obese

What is causing this?

 Socioecological model- proximal and distal, as well as, social and physical environments which effect an individual’s
behavior
 Individual is at center of influence
 Interpersonal influences, social environmental influences, physical environments, and policy environment directly
influence individual behavior and affect proximal influences
 Social cognitive theory
 Factors that are nonmodifiable: genetics
 Factors that are modifiable: skills, intention, family and peer modeling
 Factors at school or community level: food, physical activity environment, cultural influence
 Factors at distal level: food production, educational policies

Physical Activity
 Any bodily movement that works your muscles and requires more energy than resting
 a complex behavior because it can be performed in various ways across numerous physical and social settings
 physical activity and exercise are not the same
 exercise= planned, structured, and repetitive bodily movement done with the goal of maintaining ones physical fitness
 physical activity can be performed in various intensities defined by using METs.
 Moderate and vigorous intensity= healthy promoting levels

Health benefits of physical activity for children and adolescents

 improved bone health (ages 3-17 years)
 improved weight status (ages 3-17 years)
 improved cardiorespiratory and muscular fitness (6-17 years)
 improved cardiometabolic health (ages 6-17 years)
 improved cognition (ages 6-13 years)
 reduced risk of depression (ages 6-13)