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Background: Bicycling is a healthy form of physical activity that can be performed by most adults as part of leisure-time (LT) activity. However, little is known about LT bicycling behaviors, especially in the rural areas of the United States. This study sought to contrast the prevalence and factors associated with LT bicycling in populations living in urban settings with those living in rural settings. Methods: The 2019 Behavior Risk Factor Survey, which contains information regarding LT physical activity behaviors among adults (N = 396,261) in the United States, was used to determine the prevalence, demographic profile, and likelihood of meeting the physical activity guidelines of LT bicyclists. The 2013 National Center for Health Statistics Urban/Rural Classification Scheme was used to classify respondents living in rural and urban settings. Results: Among US adults, 3.8% (95% CI, 3.7–3.9) reported LT bicycling activity, the sixth most common physical activity. Adults living in urban counties compared with rural counties had a greater prevalence of LT bicycling (3.9% vs 2.3%, respectively), with adults living in rural counties having a 34% lower probability of LT bicycling. Rural bicycling prevalence rates were lower across all demographics. Urban bicyclists, compared with rural bicyclists, cycled more months of the year. Overall, 85.5% of all bicyclists met the aerobic physical guidelines, with no differences between urban and rural bicyclists. Conclusions: Bicycling remains an important LT physical activity among adults in the United States. However, a rural–urban difference in the prevalence does exist for LT bicycling. The reasons for this disparity warrant further investigation. [ABSTRACT FROM AUTHOR]

Objective: Student football managers have demands on their time that may pose barriers to meeting recommended current physical activity (PA) guidelines. The study sought to assess the amount of PA obtained by student football managers at a NCAA Division I Football university. Participants: Subjects were student football managers (n = 14) with data collected in the fall 2015. Methods: Participants wore an Omron HJ-720ITFFP pedometer for seven consecutive days during football activities only, while self-reporting their overall PA on day 7. Measures were analyzed using repeated measures and mixed-design ANOVAs. Results: Managers averaged 8474 steps/day for each practice/game. All PA measures significantly varied by day and manager experience. Overall PA equated to 78 hours of walking. Conclusions: Student football managers easily met and surpassed the recommended aerobic health-enhancing PA guideline. While their manager-related PA was 140 minutes per week, other PA allowed them to easily reach significantly healthy levels of PA.

Background: Previous studies have indicated an inverse relationship between aerobic physical activity (PA) and risk of diabetes-related mortality (DRM). However, the contribution of aerobic PA across multiple domains, while also considering the contribution of muscle-strengthening activity (MSA), in reduction of risk for DRM has yet to be examined. Purpose: The aim of this study is to examine the individual and combined associations of aerobic PA and MSA with DRM. Methods: The study sample (n = 13,350) included adult (20–79 years of age) participants from the 1999 to 2006 National Health and Nutrition Examination Survey. PA was categorized into 6 categories based around the 2018 PA guidelines: category 1 (inactive), category 2 (insufficient aerobic PA and no MSA), category 3 [active (aerobic) and no MSA], category 4 (no aerobic PA and sufficient MSA), category 5 (insufficient aerobic PA and sufficient MSA), and category 6 (meeting both recommendations). The dependent variable in this study was DRM, which includes those who had diabetes as the primary cause of death as well as those with diabetes listed as an underlying cause of death. Cox proportional hazards models were used for all analyses. Results: Following adjustment for covariates, significant risk reductions for DRM were found only in category 3 (HR = 0.57; 95% confidence interval: 0.37–0.88). Conclusions: Results suggest that meeting the aerobic PA guidelines significantly reduces the risk for DRM. Those meeting versus not meeting the MSA guidelines seem to have no difference in risk for DRM independent of aerobic PA. [ABSTRACT FROM AUTHOR]

African American (AA) women have disproportionately high physical inactivity and obesity prevalence rates in comparison to their gender and racial counterparts. AA women experience unique barriers to leisure-time physical activity (LTPA); however, methods to overcome these barriers are less developed. Therefore, this study used semistructured interviews to explore strategies of young, active AA women that support LTPA maintenance and to identify their psychosocial and behavioral characteristics. The International Physical Activity Questionnaire-long was also administered to provide descriptors of participants' LTPA. Ten women (age: M = 26.1, SD = 1.7 years) who met national guidelines for aerobic or muscle-strengthening LTPA at least 6 months (aerobic LTPA: M = 2,578.0, SD = 1,228.5 metabolic equivalent-minutes [MET-min]/week; muscle-strengthening physical activity: M = 4.0, SD = 1.9 days/week) completed the study. Four categories emerged from the interviews: (a) early-life contributors to LTPA participation, (b) characteristics of current LTPA, (c) initiating LTPA participation, and (d) maintaining LTPA participation. Findings revealed participants identified weightlifting as a preferred type of LTPA, identified various planning/preparation methods to overcome LTPA challenges, and relied on social media to initiate and maintain LTPA. This study identified several strategies used by young AA women to maintain regular LTPA and program preferences. These data are important in this understudied group as similar strategies may help inactive young AA women overcome LTPA challenges and promote long-term adherence. This could help prevent health and physical activity disparities in this population. [ABSTRACT FROM AUTHOR]

(1) Background: The developmental model describes possible mechanisms that could impact the trajectory of children and adolescents' health behaviors related to obesity; however, few data are available that support this model in the adolescent population. This study investigated the associations among motor competence (MC), moderate-to-vigorous physical activity (MVPA), perceived motor competence (PMC), and aerobic fitness in children and adolescents and the mediating and moderating effects of PMC, aerobic fitness, and weight status on the MC–MVPA relationship. (2) Methods: Participants included 47 adolescents (12.2 ± 1.6 y; 55% male) who completed the Bruininks–Oseretsky Test of Motor Proficiency, 2nd Edition (MC), Harter's perceived self-competency questionnaire (PMC), and the PACER test (aerobic fitness) and whose MVPA was measured via accelerometry. The body mass index (BMI) was calculated from measured height and weight. (3) Results: There were positive correlations between MC and fitness [rs(47) = 0.469, p < 0.01], PMC and fitness [rs(47) = 0.682, p < 0.01], and PMC and MC [rs(47) = 0.416, p < 0.01]. There were no associations among MVPA and MC, PMC, or fitness (p > 0.05). There were inverse associations between BMI and both MVPA [rs(44) = −0.410, p < 0.01] and fitness [rs(47) = 0.295, p < 0.05]. The association between MC and MVPA was mediated by fitness (β = 0.3984; 95% CI (0.0564–0.7985)). (4) Conclusions: The associations among MC, PMC, and fitness highlight the critical role of MC in health and partially support the proposed developmental model concerning the relationships that exist among MC, MVPA, PMC, fitness, and BMI. [ABSTRACT FROM AUTHOR]

Regular physical activity (PA) is an important concept to measure in health education research. The health education researcher might need to measure physical activity because it is the primary measure of interest, or PA might be a confounding measure that needs to be controlled for in statistical analysis. The purpose of this commentary is to describe the methods and approaches for measuring physical activity that are most appropriate to health education evaluation and research. The researcher can select from objective approaches (e.g., direct observation, accelerometers) that are more precise in measuring physical activity or subjective approaches (e.g., logs, interviews, surveys) that are more practical in terms of administration but are inherently more imprecise due to sources of recall error related to self-report.

Background: School-aged children in the Southeast, compared with other United States of America (US) regions, have significantly lower levels of active transportation to school (ATS). The purpose of this study was to contrast the parental correlates of ATS choice specific to the Southeast with other areas of the US. Methods: This study utilized national data from 2952 households with school-aged children located within a 20-minute walk to a school. Parents reported their children's ATS behavior and their own ATS beliefs and perceptions. Logistic regression contrasted correlates of parents from the Southeast with other regions. Results: Parents in the Southeast, compared with parents across the US, were significantly less likely to allow their child to take ATS (12.9% vs 33.3%, respectively) (odds ratio [OR] = 0.46; 95% confidence interval [CI] = 0.36–0.59). Specific to the Southeast, parental correlates linked to increases in ATS were Black race/ethnicity (OR = 1.68; 95% CI, 1.31–2.60), being single, (OR = 1.71; 95% CI, 1.15–2.54), and any parental physical activity (P value for trend =.0053). The only correlate associated with a decrease in ATS in the Southeast was heightened safety concerns (eg, traffic speed, safe crossings) (OR = 0.44; 95% CI, 0.23–0.84). Conclusions: Among households with children in the Southeast, ATS interventions that allay parental safety concerns and that promote physical activity among parents might lead to increases in ATS. [ABSTRACT FROM AUTHOR]

Context: Approximately 70% of US women over age 40 report mammography screening within 2 years. However, rates are likely to vary by age, income, educational level, and residence. Purpose: To describe the prevalence of screening mammography and associated factors in women living in rural and urban areas of Tennessee. Methods: Using pooled data from the Tennessee Behavioral Risk Factor Surveillance System (BRFSS; 2001 and 2003), utilization of screening mammography within a 2-year period was examined for a sample of 1,922 women, 40 years and older. Demographic, behavior, and health-related variables were used to examine associations with utilization. Findings: The prevalence of screening mammography utilization (71.3% 95% CI 67.4-75.2) in women living in rural areas of Tennessee was significantly lower than utilization among women living in urban areas (78.3% 95% CI 75.9-80.7). Higher utilization was associated with having attained at least a high school education, having health insurance, identifying a personal health care provider, being a nonsmoker, recent use of alcohol, having had a recent clinical breast exam or Papanicolau (Pap) test done, and meeting the Healthy People 2010 (HP 2010) recommendation for physical activity. After controlling for all other factors, rural residence was not associated with utilization. For rural women, identifying a personal health care provider was significantly associated with increased likelihood of utilization. Conclusions: Lower income and lower education, each associated with lower screening utilization, were more common in rural Tennessee women. The significance of a personal health care provider for utilization in rural women is meaningful for service providers.

Background: The purpose of this study was to assess the school breakfast environment in rural Appalachian schools to inform school environment intervention and policy change. Methods: A total of 4 rural schools with fourth- and fifth-grade students in East Tennessee were assessed. A cross-sectional descriptive examination of the school food environment where food service managers submitted school menus, production sheets, and vendor bid sheets as part of the dietary data collection protocol for a school-based nutrition intervention study. The school breakfast environment was characterized in terms of calories, fat, saturated fat, and fiber from foods served on a per person basis using menus entered into Nutrient Data Systems for Research and production sheets for amounts of each food item served. Food items were grouped by the meal components of the School Breakfast Program (SBP) and ranked according to the items served most frequently. Results: Total fat provided slightly less than half the calories (43%); 15% of calories were from saturated fat. The top-ranked foods for each meal component were biscuits, sausage, 2% milk, orange juice, and gravy. Conclusions: Results suggest that clearer policies or regulations for the SBP are warranted to support policy efforts to promote childhood health. These should include technical assistance and provision of resources for school food service managers to provide low-fat meal options. Further research is needed to determine whether what is offered at school breakfast is actually consumed and how that might affect children's weight because of the high fat content. (Contains 2 tables.)

Background: Little is known about the daily physical activity (PA) levels of people employed in different occupational categories. Methods: Nine ActiGraph accelerometer-derived daily PA variables are presented and ranked for adults (N = 1465, 20–60 y) working in the 22 occupational categories assessed by NHANES 2005–2006. A composite score was generated for each occupational category by summing the rankings of 3 accelerometer-derived daily PA variables known to have strong associations with health outcomes (total activity counts [TAC], moderate to vigorous PA minutes per week in modified 10-minute bouts [MVPA 10], and percentage of time spent in sedentary activity [SB%]). Results: Classified as high-activity occupational categories, "farming, fishing, forestry," and "building & grounds cleaning, maintenance" occupations had the greatest TAC (461 996 and 449 452), most MVPA 10 (149.6 and 97.8), most steps per day (10 464 and 11 602), and near the lowest SB% (45.2% and 45.4%). "Community, social services" occupations, classified as low-activity occupational categories, had the second lowest TAC (242 085), least MVPA 10 (12.1), fewest steps per day (5684), and near the highest SB% (64.2%). Conclusions: There is a strong association between occupational category and daily activity levels. Objectively measured daily PA permitted the classification of the 22 different occupational categories into 3 activity groupings. [ABSTRACT FROM AUTHOR]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2006.06.011 Byline: Debra K. Goodwin, Linda L. Knol, James M. Eddy, Eugene C. Fitzhugh, Olivia W. Kendrick, Roberta E. Donahue Abstract: The objective of this study was to compare the quality of overall dietary intake of US adolescents by self-rated health status. Using 2 nonconsecutive days of dietary recall data and responses to a single question describing self-rated health status from the Continuing Survey of Food Intakes by Individuals 1994-1996, linear regression analysis was used to detect differences in Healthy Eating Index (HEI) scores by self-rated health status for 1,504 adolescents, ages 11 to 18 years. After adjusting for factors related to both overall dietary quality and self-rated health status, overall HEI scores did not differ by self-reported health status. However, two individual HEI component scores were found to be significantly related to adolescent self-rated health status: the vegetables score (P=0.01) was higher among those with positive self-rated health status, and the total fat score (P=0.01) was higher among those with negative self-rated health status. Self-perception of health status is not related to the overall quality of the adolescent diet; therefore, food and nutrition professionals should focus on understanding motivators other than health status when exploring adolescent dietary behaviors.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2006.05.010 Byline: Linda L. Knol, Betsy Haughton, Eugene C. Fitzhugh Abstract: The purpose of this study was twofold: (a) develop and test the potential usefulness of a new measure of dietary adherence to the US Department of Agriculture (USDA) Food Guide and (b) use this measure to assess the diets of children in the United States.

Objective The purpose of this study was to identify dietary patterns of young, low-income US children, describe differences in diet quality between identified patterns, and make targeted food recommendations to improve diet quality. Design Dietary patterns were assessed using dietary variables from the Pyramid Servings Database within the Continuing Survey of Food Intakes by Individuals 1994-1996, 1998. Healthy Eating Index (HEI) scores were used to validate identified dietary patterns. Subjects/setting Two subsamples of low-income children, aged 2 to 3 years (n = 1,242) and 4 to 8 years (n = 1,506), were selected from the Continuing Survey of Food Intakes by Individuals data. Statistical analysis Cluster analysis was performed to determine unique dietary patterns within the two subsamples. Linear regression analyses were used to compare energy intake, discretionary fat, added sugars, and HEI scores across cluster groups. Descriptive statistics were computed for each cluster. Results Cluster analysis identified six and seven distinct dietary patterns for the younger and older children, respectively. Four patterns were similar for both age groups. For the 2- to 3-year-old children, energy intake, overall HEI scores, and nine of the 10 HEI component scores differed among the four most prevalent dietary patterns. Among the older children, energy intake and six of the HEI component scores differed between the four most prevalent clusters but not overall HEI. Conclusions Neither age group had a cluster of children who followed a balanced/moderate diet pattern consistent with Food Guide Pyramid recommendations. Children consuming almost every pattern identified could benefit by reducing added sugars and discretionary fat and increasing low-fat, low-sugar options from the vegetables, fruits, meat, and milk groups. J Am Diet Assoc. 2005;105:1765-1773.

This study explored the relationship between food sufficiency status and redundancy of food choices, or dietary variety, among children in low-income families using the Variety Score from the Healthy Eating Index. Two samples of children ages 2 to 3 (n = 1,242) and 4 to 8 years (n = 1,506) were selected from the Continuing Survey of Food Intakes by Individuals 1994-1996, 1998 and then classified as either food sufficient, food sufficient with limitations, or food insufficient. Mean variety scores were low for all children, but did not differ by food sufficiency status for either age group. However, they did differ by Special Supplemental Nutrition Program for Women, Infants, and Children participation and region of the country for the younger and older children, respectively. Results suggest the importance of nutrition education and food assistance programs that enhance dietary variety. Further research should explore how food assistance program participation is related to dietary variety and the degree to which variety within food groups is related to food security. J Am Diet Assoc. 2004;104:640-644.