scholarly journals Joint associations of fruit and vegetable consumption and physical activity with mortality risk

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E Mauramo ◽  
J Salmela ◽  
N Kanerva ◽  
E Lahelma ◽  
T Lallukka ◽  
...  

Abstract Background Fruit and vegetable consumption (FVC) and leisure-time physical activity (LTPA) are associated with better health outcomes but less is known about their joint associations with the risk of mortality. We examined the joint associations of FVC and LTPA with premature mortality among midlife and ageing municipal employees, adjusting for key covariates. Methods Survey data collected in 2000–2002 among 40–60-year-old employees of the City of Helsinki, Finland, were linked with complete register data on mortality from Statistics Finland (4961 women, 1373 men; response rate 67%; written consent for register linkages 74%). FVC was dichotomised into daily or non-daily, and LTPA into high (>14 MET-hours/week including vigorous exercise) or low. Covariates included age, sex, marital status, socioeconomic position, binge drinking, smoking and self-rated health. Cox regression models were fitted. The follow-up continued until the event of death or the end of 2015. Results A total of 281 deaths occurred during the follow-up. The mortality rate was 7.1% in men and 3.7% in women. A gender interaction was found, showing differing associations for women and men. Men with both daily FVC and high LTPA had the lowest mortality risk (HR 0.19, 95% CI 0.06-0.63) after adjusting for covariates. Men with high LTPA and non-daily FVC also had a lower mortality risk (HR 0.51, 95% CI 0.29-0.90) compared to those with non-daily FVC and low LTPA. Women with daily FVC and high LTPA had a lower mortality risk initially, but after adjusting for covariates no statistically significant associations were observed. Conclusions The joint associations of FVC and LTPA with premature mortality differed between women and men. This could be related to gender differences in e.g. the causes of death, and further studies are needed to clarify this. Increasing FVC and LTPA might prevent premature mortality among men. Key messages Fruit and vegetable consumption jointly with physical activity decreased the risk of premature mortality among men only. Further studies are needed to clarify the gender difference which could be related to for example death causes.

2016 ◽  
Vol 4 (7) ◽  
pp. 1-156 ◽  
Author(s):  
Debbie A Lawlor ◽  
Ruth R Kipping ◽  
Emma L Anderson ◽  
Laura D Howe ◽  
Catherine R Chittleborough ◽  
...  

BackgroundPrevious studies of the effect of school-based interventions to improve healthy behaviours have had important limitations.ObjectiveTo investigate the effectiveness of a school-based intervention to increase physical activity, reduce sedentary behaviour and increase fruit and vegetable consumption.DesignCluster randomised controlled trial.SettingSixty English primary schools.ParticipantsChildren in year 4 (aged 8–9 years) at recruitment, year 5 (aged 9–10 years) during the intervention and immediate follow-up and year 6 (aged 10–11 years) during 1 year of follow-up.InterventionActive for Life Year 5 (AFLY5) included teacher training, lesson plans, materials for 16 lessons, parent-interactive homework and written materials for school newsletters and parents.Main outcome measuresPrimary outcome measures included accelerometer-assessed levels of physical activity and sedentary behaviour, and child-reported consumption of fruit and vegetables. Secondary outcome measures included child-reported screen viewing; consumption of snacks, high-fat food and high-energy drinks; body mass index; and waist circumference.ResultsWe recruited 60 schools (2221 children). At the immediate follow-up, no difference was found between children in intervention and control schools for any of the three primary outcomes. The intervention was effective on three of the nine secondary outcomes; children in intervention schools reported spending less time screen viewing at weekends [–21 minutes per day, 95% confidence interval (CI) –37 to –4 minutes per day], eating fewer servings of snacks per day (–0.22, 95% CI –0.38 to –0.05 servings of snacks per day) and drinking fewer servings of high-energy drinks per day (–0.26, 95% CI –0.43 to –0.10 servings of high-energy drinks per day) than the children in control schools. The results remained consistent 1 year later. The intervention increased children’s perception of maternal efforts to limit the time they spent screen viewing and children’s knowledge about healthy physical activity and fruit and vegetable consumption, with these two mediators explaining approximately one-quarter of the effect of the intervention on screen viewing. The intervention did not affect other mediators. The cost of implementing the intervention from a provider perspective was approximately £18 per child. Process evaluation showed that AFLY5 was implemented with a high degree of fidelity. Teachers supported the aims of AFLY5, but their views of the programme itself were mixed.LimitationsResponses to parental questionnaires for the economic evaluation were low and we struggled to engage all teachers for the process evaluation. Although the participating schools included a range of levels of socioeconomic deprivation, class sizes and rural and urban settings, we cannot assume that results generalise to all primary schools.ConclusionsAFLY5 is not effective at increasing levels of physical activity, reducing sedentary behaviour and increasing fruit and vegetable consumption in primary school children, but may be effective in reducing time spent screen viewing at weekends and the consumption of snacks and high-energy drinks.Future workOur findings suggest that school-based interventions are unlikely to have a major impact on promoting healthy levels of physical activity and healthy diets in primary school children. We would recommend trials of the effect and cost-effectiveness of more intensive family and community interventions.Trial registrationCurrent Controlled Trials ISRCTN50133740.FundingThis project was funded by the National Institute for Health Research Public Health Research programme and will be published in full inPublic Health Research; Vol. 4, No. 7. See the NIHR Journals Library website for further project information.


2018 ◽  
Vol 12 ◽  
pp. 117955651878429 ◽  
Author(s):  
Jessyka N Larson ◽  
Timothy A Brusseau ◽  
Heidi Wengreen ◽  
Stuart J Fairclough ◽  
Maria M Newton ◽  
...  

Efforts to decrease the risk of overweight and obesity should focus on children’s physical activity (PA) and fruit and vegetable (FV) consumption. Within school-based interventions, there is insufficient evidence on the effectiveness of the use of character modeling and goal setting to determine changes in step counts, MVPA, and FV consumption. Study participants were 187 students in grades 4 and 5 from 2 Title 1 elementary schools in the Southwest United States. The intervention was a quasi-experimental character modeling and goal setting program. New Lifestyles NL-1000 activity monitors were used to assess number of steps taken and MVPA by the participants. Fruit and vegetable consumption was measured by direct observation. School day steps, MVPA, and FV consumption were recorded at baseline, intervention, and during a 10-week follow-up. There were not differences between groups at baseline. Steps and MVPA were statistically significantly ( P < .05; Δ = ~2500 steps and ~5 minutes of MVPA) greater in the intervention compared with the control group over time. Fruit and vegetable consumption was not significantly ( P = .308) greater in the intervention compared with the control group over time. Students in the intervention school were significantly more active than students in the control school during the intervention phase and at follow-up. The findings reported here would suggest that character modeling and goal setting can increase PA among elementary aged children but did not increase FV consumption.


2019 ◽  
Author(s):  
Michelle C Krzyzanowski ◽  
Paul N Kizakevich ◽  
Vanessa Duren-Winfield ◽  
Randall Eckhoff ◽  
Joel Hampton ◽  
...  

BACKGROUND With the increasing use of mobile devices to access the internet and as the main computing system of apps, there is a growing market for mobile health apps to provide self-care advice. Their effectiveness with regard to diet and fitness tracking, for example, needs to be examined. The majority of American adults fail to meet daily recommendations for healthy behavior. Testing user engagement with an app in a controlled environment can provide insight into what is effective and not effective in an app focused on improving diet and exercise. OBJECTIVE We developed Rams Have Heart, a mobile app, to support a cardiovascular disease (CVD) intervention course. The app tracks healthy behaviors, including fruit and vegetable consumption and physical activity, throughout the day. This paper aimed to present its functionality and evaluated adherence among the African American college student population. METHODS We developed the app using the Personal Health Informatics and Intervention Toolkit, a software framework. Rams Have Heart integrates self-reported health screening with health education, diary tracking, and user feedback modules to acquire data and assess progress. The parent study, conducted at a historically black college and university-designated institution in southeastern United States, consisted of a semester-long intervention administered as an academic course in the fall, for 3 consecutive years. Changes were made after the cohort 1 pilot study, so results only include cohorts 2 and 3, comprising a total of 115 students (n=55 intervention participants and n=54 control participants) aged from 17 to 24 years. Data collected over the study period were transferred using the secure Hypertext Transfer Protocol Secure protocol and stored in a secure Structured Query Language server database accessible only to authorized persons. SAS software was used to analyze the overall app usage and the specific results collected. RESULTS Of the 55 students in the intervention group, 27 (49%) students in cohort 2 and 25 (45%) in cohort 3 used the Rams Have Heart app at least once. Over the course of the fall semester, app participation dropped off gradually until exam week when most students no longer participated. The average fruit and vegetable intake increased slightly, and activity levels decreased over the study period. CONCLUSIONS Rams Have Heart was developed to allow daily tracking of fruit and vegetable intake and physical activity to support a CVD risk intervention for a student demographic susceptible to obesity, heart disease, and type 2 diabetes. We conducted an analysis of app usage, function, and user results. Although a mobile app provides privacy and flexibility for user participation in a research study, Rams Have Heart did not improve compliance or user outcomes. Health-oriented research studies relying on apps in support of user goals need further evaluation.


2021 ◽  
Author(s):  
Bozena Wielgoszewska ◽  
Jane Maddock ◽  
Michael J Green ◽  
Giorgio Di Gessa ◽  
Sam Parsons ◽  
...  

Background: In March 2020 the UK implemented the Coronavirus Job Retention Scheme (furlough) to minimize job losses. Our aim was to investigate associations between furlough and diet, physical activity, and sleep during the early stages of the pandemic. Methods: We analysed data from 25,092 participants aged 16 to 66 years from eight UK longitudinal studies. Changes in employment (including being furloughed) were defined by comparing employment status pre- and during the first lockdown. Health behaviours included fruit and vegetable consumption, physical activity, and sleeping patterns. Study-specific estimates obtained using modified Poisson regression, adjusting for socio-demographic characteristics and pre-pandemic health and health behaviours, were statistically pooled. Associations were also stratified by sex, age, and education. Findings: Across studies, between 8 and 25% of participants were furloughed. Compared to those who remained working, furloughed workers were slightly less likely to be physically inactive (RRR:0.85, [0.75-0.97], I2=58.7%) and did not differ in diet and sleep behaviours. In stratified analyses, furlough was associated with low fruit and vegetable consumption among males (RRR=1.11; 95%CI: 1.01-1.22; I2: 0%) but not females (RRR=0.84; 95%CI: 0.68-1.04; I2: 65%). Considering change in behaviour, furloughed workers were more likely than those who remained working to report increased fruit and vegetable consumption, exercise, and hours of sleep. Interpretation: Those furloughed exhibited broadly similar levels of health behaviours with those who remained in employment during the initial stages of the pandemic. Social protection policies in the post-pandemic recovery period and during future economic crises may help protect population health. Funding: Medical Research Council.


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