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Abstract Educational Leadership in Teaching Excellence (EnLITE) is an 11-month faculty development program at the University of Guelph, Ontario. Created and led by faculty members and educational developers, EnLITE is designed to engage participants in the principles, practice and theory of teaching and learning in higher education and to promote a learner-centred approach to teaching. Participants critically examine and discuss scholarly topics on teaching and learning and in their own disciplines; collaborate with one or more teaching mentors; engage in peer classroom observation; and participate in other teaching-related activities informed by their individual learning plans. Our objective was to determine the perceived impact of EnLITE on participants' teaching-related practices and experiences. We collected pre-, post- and one-year post-program quantitative and qualitative survey responses from each of the 2014-2015, 2015-2016 and 2016-2017 EnLITE cohorts (N = 17 participants representing a variety of disciplines; 71% female). There were significant improvements in participants' perceived teaching practices related to critical self-reflection (13% increase from pre- to one-year post-program), student engagement (+28.2%), collaborative learning (+31%) and learner-centred pedagogy (+22.9%, all p < 0.05). There was little to no change in use of technology, student assessment, leadership, participation in communities of practice, or dissemination of teaching-related scholarship. These results provide empirical evidence of the effectiveness of a peer-driven faculty development program in promoting a learning-centred approach to teaching. Future research should determine whether these changes translate into improved student learning, and whether such programs demonstrate longer term improvements in engagement in teaching-related leadership, communities of practice and dissemination.

Excess dietary sugar intake increases the risk of unhealthy weight gain, an important cardiometabolic risk factor in children. To further our understanding of this relationship, we performed a narrative review using two approaches. First, research examining dietary sugar intake, its associations with cardiometabolic health, impact of genetics on sweet taste perception and intake, and how genetics moderates the association of dietary sugar intake and cardiometabolic risk factors in preschool-aged children 1.5-5 years old is reviewed. Second, methodological considerations for collecting and analyzing dietary intake of sugar, genetic information, and markers of cardiometabolic health among young children are provided. Our key recommendations include the following for researchers: (1) Further longitudinal research on sugar intake and cardiometabolic risk factors is warranted to inform policy decisions and guidelines for healthy eating in preschool-aged children. (2) Consistency in sugar definitions is needed across research studies to aid with comparisons of results. (3) Select dietary collection tools specific to each study's aim and sugar definition(s). (4) Limit subjectivity of dietary assessment tools as this impacts interpretation of study results. (5) Choose non-invasive biomarkers of cardiometabolic disease until the strengths and limitations of available biomarkers in preschool-aged children are clarified. (6) Select approaches that account for the polygenic nature of cardiometabolic disease such as genome risk scores and genome wide association studies to assess how genetics moderates the relationship between dietary sugar intake and cardiometabolic risk. This review highlights potential recommendations that will support a research environment to help inform policy decisions and healthy eating policies to reduce cardiometabolic risk in young children. [ABSTRACT FROM AUTHOR]

Simple Summary: The sociodemographic characteristics of a parent and child may predispose young children to excessive dietary sugar intake; however, there is limited research available on this topic. The aim of this cross-sectional analysis was to examine the impact of sociodemographic characteristics such as child age, child sex, child ethnicity, parent number of years living in Canada, annual household income, parent education and parent marital status on total, free and added sugar intake in young children. Dietary and sociodemographic data including 267 children from 210 families participating in the Guelph Family Health Study were examined. The results indicate that child age, child ethnicity and annual household income can play a crucial role in shaping sugar intake in young children. This research may help inform future research and program interventions early in life along with guiding parents to decrease sugar intake in young children. Background: It is crucial to develop strategies targeted to promote healthy eating patterns in vulnerable populations, especially young children from diverse sociodemographic groups. Thus, the study objective was to investigate the associations between child age, child sex, child ethnicity, parent number of years living in Canada, annual household income, parent education and parent marital status with total, free and added sugar intakes in young children. Methods: This cross-sectional study was a secondary analysis of data gathered in the Guelph Family Health Study. The study included 267 children (129M; 138F) from 210 families aged 1.5 to 5 years. Parents completed questionnaires for children on sociodemographic characteristics and an online 24-hour diet recall. The associations between sociodemographic characteristics and sugar intakes were determined using generalized estimating equations applied to linear regression models. Results: The mean age of the children was 3.5 ± 1.2 years (mean ± std dev.). As children's age increased, there was a greater intake of free and added sugar ( β ^ = 8.6, p = 0.01, 95% CI = 2.4 to 14.7 and β ^ = 6.5, p = 0.03, 95% CI = 0.8 to 12.2, respectively). Those children who identified as white had a higher total sugar intake than children of other ethnicities ( β ^ = 31.0, p = 0.01, 95% CI = 7.2 to 54.7). Additionally, higher annual household income was associated with lower was free sugar intake in children ( β ^ = −2.4, p = 0.02, 95% CI = −4.5 to −0.4). Conclusions: This study underscores the significant influence of multiple sociodemographic characteristics on sugar intake in young children, providing valuable insights for public health policy and nutrition interventions. Moreover, this study highlights the need for early behaviour interventions focusing on reducing sugar intake in young children, while considering sociodemographic factors. [ABSTRACT FROM AUTHOR]

There is limited research on the intake of non-nutritive sweeteners (NNS) among preschool-aged children. Canada's Food Guide suggests limiting intake of NNS for all population groups and Health Canada recommends that young children (<2 years) avoid consuming beverages containing NNS. The aim of this study was to investigate the frequency and type of non-nutritive sweetener (NNS) intake in preschool-aged children participating in the Guelph Family Health Study pilots. Parents (n = 78 families) completed 3-day food records (n = 112 children; n = 55 females, n = 57 males; 3.6 years ± 1.3). Nineteen children (17%) reported consumption of foods or beverages containing NNS. Food sources with NNS included: freezies, oral nutritional supplements, flavored water, carbonated drinks, sugar free jam and protein powder. The majority of NNS contained in these foods were identified as stevia leaf extract, acesulfame K, sucralose, monk fruit extract and aspartame. Future research should continue to study NNS intake patterns longitudinally in children and examine the association of NNS intake with diet quality and health outcomes. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore barriers and facilitators of the provision of dairy and plant-based dairy alternatives (PBDA) by parents of preschool-age children, a previously unexplored area of research.Design: Five focus groups of parents were conducted and audio-recorded. Verbatim transcripts were analysed using thematic analysis.Setting: University of Guelph, in Guelph, ON, Canada in 2019.Participants: Thirty-two (n 19 mothers, 13 fathers) parents of preschool-age children. Most (59 %) were university or college educated.Results: Facilitators common to both dairy and PBDA provision included perceived nutritional benefits, such as dairy's Ca, protein and fat content, and PBDA's protein content, and the perception that PBDA adds variety to the diet. Facilitators unique to dairy v. PBDA provision included the taste of, familiarity with, and greater variety and accessibility of dairy products, specifically child-friendly products. A facilitator unique to PBDA v. dairy provision was ethical concerns regarding dairy farming practices. Barriers common to both dairy and PBDA provision included perceived cost, concerns regarding the environmental impact of production, and high sugar content. Barriers specific to dairy included use of antibiotics and hormones in dairy production. A barrier specific to PBDA was the use of pesticides.Conclusion: Behaviour change messages targeting parents of preschoolers can emphasise the nutrition non-equivalence of dairy and some PBDA and can educate parents on sources of affordable, unsweetened dairy and PBDA. [ABSTRACT FROM AUTHOR]

Objective: Approximately 25 % of Canadian children aged 4-8 years fail to meet the recommended dietary allowance (RDA) of calcium (Ca). Young children's food choices are primarily determined by their parents. No interventions have directly targeted parents as a medium through which to increase children's Ca consumption. This study compared the effectiveness of a Ca-specific intervention targeted towards parents, with generic dietary advice on the Ca consumption of children aged 4-10 years.Design: A parallel two-arm randomised controlled trial was conducted.Setting: The study was conducted across Canada. Both conditions received information on the RDA of Ca and an index of intake requirements. Material sent to the intervention condition included behavioural strategies to increase dietary Ca consumption, information on the benefits of dietary Ca intake and messages addressing perceived barriers to the consumption of Ca-rich foods.Participants: A total of 239 parents (93 % mothers) of children aged 4-10 years who consumed less than the RDA of Ca were randomly assigned in a 1:1 allocation ratio.Results: There was a significant increase in total Ca intake and Ca from dairy for children at weeks 8, 34 and 52 (P ≤ 0·001) in both conditions. Parental Ca intake and amount spent on dairy products did not significantly increase following the intervention.Conclusions: Provision of daily Ca requirements with regular reminders could impact parents' delivery of Ca-rich foods to their children. This finding is important for public health messaging as it suggests that parents are a potent medium through which to promote Ca intake in children. [ABSTRACT FROM AUTHOR]

Background: Excessive intake of sugar in young children is a public health concern. Our study objectives were to examine intakes of total, free and added sugar among preschool-aged children and to investigate their associations with body weight, body mass index Z-scores, percent fat mass and waist circumference. Methods: The cross-sectional cohort study included preschool-aged children between 1.5 and 5 years of age, enrolled in pilot studies of the Guelph Family Health Study, Guelph, Ontario, from 2014 to 2016. Daily intake of total sugar was determined using a food processor software; daily intakes of free and added sugar, and food sources were determined through manual inspection of 3-day food records. Anthropometric measures were completed by trained research staff. We used linear regression models with generalized estimating equations to estimate associations between sugar intakes and anthropometric measures. Results: We included 109 children (55 girls and 54 boys) in 77 families. Mean daily intakes were 86 (standard deviation [SD] 26) g for total sugar, 31 (SD 15) g for free sugar and 26 (SD 13) g for added sugar. Of participants, 80% (n = 87) had intakes of free sugar greater than 5% of their daily energy intake. The most frequent food sources of free and added sugar were bakery products. A weak inverse association between free sugar intake (kcal/1000 kcal) and waist circumference (cm) (β = −0.02, 95% confidence interval −0.04 to −0.0009) was found, but no significant associations were noted between sugar intake and other anthropometric measures. Interpretation: Most of the preschool-aged children in this study had free sugar intakes greater than current recommendations; overall, their total, free and added sugar intakes were not associated with the anthropometric measures. This study can be used to inform policy development for sugar intake in young children and apprise early intervention programs. [ABSTRACT FROM AUTHOR]

Objective: This study investigated associations between stress (general stress, parenting distress, and household chaos) and adiposity among parents of young children.Methods: The sample consisted of 49 mothers and 61 fathers from 70 families with young children living in Ontario, Canada. Linear regression using generalized estimating equations was used to investigate associations between stress measures and BMI, waist circumference (WC), waist to height ratio (WHtR), and percent fat mass.Results: General stress was significantly associated with BMI ( β^  = 0.54; 95% CI: 0.04-1.03) and WC ( β^  = 1.44; 95% CI: 0.10-2.77). Parenting distress was significantly associated with BMI ( β^  = 0.16; 95% CI: 0.02-0.31), WC ( β^  = 0.39; 95% CI: 0.04-0.75), and WHtR ( β^  = 0.003; 95% CI: 0.001-0.005). Household chaos was significantly associated with all adiposity measures (BMI: β^  = 0.20 [95% CI: 0.08-0.33]; WC: β^  = 0.48 [95% CI: 0.21-0.75]; WHtR: β^  = 0.003 [95% CI: 0.001-0.005]; percent fat mass: β^  = 0.29 [95% CI: 0.08-0.49]).Conclusions: General stress, parenting distress, and household chaos are associated with adiposity among parents of young children. Future research should elucidate mechanisms by which this occurs and elucidate how this risk may be mitigated. [ABSTRACT FROM AUTHOR]

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Being nominated for and receiving a teaching award can be career-altering for university faculty members. In this reflective paper, we describe our experiences as mid-career faculty members serving on a provincial university teaching awards committee, a role which we argue can be equally career-altering. We reflect on all steps of the process, including the review of nomination dossiers of faculty members from a variety of academic disciplines and against a similarly wide variety of criteria, the selection meeting, preparing citations and feedback letters, and the awards ceremony. Each step of the process has encouraged us to view our teaching through what Stephen Brookfield refers to as an "autobiographical lens," while also considering student, colleague and theoretical perspectives of teaching and learning. Serving on a university teaching awards committee has encouraged us to evolve, both professionally and personally. [ABSTRACT FROM AUTHOR]

Snacking is an integral component of eating habits in young children that is often overlooked in nutrition research. While snacking is a substantial source of calories in preschoolers' diets, there is limited knowledge about the factors that drive snacking patterns. The genetics of taste may help to better understand the snacking patterns of children. The rs1761667 single nucleotide polymorphism (SNP) in the CD36 gene has been linked to fat taste sensitivity, the rs35874116 SNP in the TAS1R2 gene has been related to sweet taste preference, and the rs713598 SNP in the TAS2R38 gene has been associated with aversion to bitter, green leafy vegetables. This study seeks to determine the cross-sectional associations between three taste receptor SNPs and snacking patterns among preschoolers in the Guelph Family Health Study. Preschoolers' snack quality, quantity, and frequency were assessed using three-day food records and saliva was collected for SNP genotyping (n = 47). Children with the TT genotype in TAS1R2 consumed snacks with significantly more calories from sugar, and these snacks were consumed mostly in the evening. Total energy density of snacks was highest in the CC and CG genotypes compared to the GG genotype in TAS2R38, and also greater in the AA genotype in CD36 compared to G allele carriers, however this difference was not individually attributable to energy from fat, carbohydrates, sugar, or protein. Genetic variation in taste receptors may influence snacking patterns of preschoolers. [ABSTRACT FROM AUTHOR]

The article discusses a study which investigated whether leg-to-leg bioelectrical impedance analysis (BIA) is sufficiently sensitive versus the reference standard four-compartment (4C) model to detect change in percentage fat mass (%FM) in overweight adults. Leg-to-leg BIA could detect minor changes in %FM with reasonable accuracy in 98 moderately obese women who lost about 8.5% of their body fat. It also found that leg-to-leg BIA may be influenced by variations in the distribution of muscle and fat mass about the body.

A low resting metabolic rate (RMR) has been proposed as a possible cause for the increased body fat commonly seen in women compared with men. Absolute RMR is higher in men, but whether RMR adjusted for lean body mass (LBM) remains higher is unresolved. The objective of the present study was to determine whether RMR adjusted for various body composition factors differed between healthy adult men and women. Thirty men (28??3??8??0 years, BMI 23??7??2??1 kg/m2) and twenty-eight women (28??7??6??9 years, BMI 22??2??1??9 kg/m2) were included in the analyses. RMR was measured by open-circuit indirect calorimetry for 60 min. Extracellular water (ECW) was measured by corrected Br- space and total body water (TBW) by 2H dilution. LBM was estimated as TBW/0??732. Intracellular water (ICW) was calculated as TBW-ECW, and body cell mass (BCM) as ICW/0??732. Men were heavier and had higher BMI, LBM, BCM and ECW, but less fat mass. Absolute RMR was higher in men than women (7280??844 v. 5485??537 kJ/d, P<0??0001). This difference became non-significant when RMR was adjusted for LBM by ANCOVA (6536??630 v. 6282??641 kJ/d, P=0??2191), but remained significant when adjusted for BCM (6680??744 v. 6128??756 kJ/d, P=0??0249). Fat mass explained a significant amount of variation in RMR in women (r2 0??28, P=0??0038), but not in men (r2 0??03, P=0??3301). The relationships between body fat and the various subcompartments of BCM and RMR require further elucidation. [ABSTRACT FROM PUBLISHER]

Dairy product consumption is important during childhood, as dairy products provide nutrients to support growth and development. However, a high proportion of children globally are not meeting recommended daily intakes, which may have long-term health implications. Accumulating evidence suggests that interventions aimed at instilling healthy lifestyle habits are most effective when initiated during the preschool years. Therefore, the purpose of the review was to identify the characteristics of effective dairy and/or calcium interventions targeting preschool-aged children. A systematic literature review identified 14 intervention studies published between 1998–2018 addressing dairy/calcium intakes in the preschool population (1.5 to 5 years). Intervention reporting was assessed using intervention intensity, behavior change techniques and Workgroup for Intervention Development and Evaluation Research (WIDER), with the quality of studies evaluated using risk of bias and Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Five of the 14 studies included in the review reported significant improvements in children's dairy (4/5) or calcium (1/5) intake. Characteristics that may enable intervention effectiveness include the delivery of interventions in one setting (preschool facility), using specific behavior change techniques (environmental restructuring and teach to use prompts/cues), and targeting both parent and child. Overall, the interventions assessed demonstrated variable success and highlighted the need for developing effective interventions designed to increase dairy and/or calcium intakes in preschool-aged children. [ABSTRACT FROM AUTHOR]

Background: Chronic stress is an important risk factor in the development of obesity. While research suggests chronic stress is linked to excess weight gain in children, the biological or behavioral mechanisms are poorly understood., Objective: The objectives of the Family Stress Study are to examine behavioral and biological pathways through which chronic stress exposure (including stress from COVID-19) may be associated with adiposity in young children, and to determine if factors such as child sex, caregiver-child relationship quality, caregiver education, and caregiver self-regulation moderate the association between chronic stress and child adiposity., Methods: The Family Stress Study is a prospective cohort study of families recruited from 2 Canadian sites: the University of Guelph in Guelph, Ontario, and McMaster University in Hamilton, Ontario. Participants will be observed for 2 years and were eligible to participate if they had at least one child (aged 2-6 years) and no plans to move from the area within the next 3 years. Study questionnaires and measures were completed remotely at baseline and will be assessed using the same methods at 1- and 2-year follow-ups. At each time point, caregivers measure and report their child's height, weight, and waist circumference, collect a hair sample for cortisol analysis, and fit their child with an activity monitor to assess the child's physical activity and sleep. Caregivers also complete a web-based health and behaviors survey with questions about family demographics, family stress, their own weight-related behaviors, and their child's mental health, as well as a 1-day dietary assessment for their child., Results: Enrollment for this study was completed in December 2021. The final second-year follow-up was completed in April 2024. This study's sample includes 359 families (359 children, 359 female caregivers, and 179 male caregivers). The children's mean (SD) age is 3.9 years (1.2 years) and 51% (n=182) are female. Approximately 74% (n=263) of children and 80% (n=431) of caregivers identify as White. Approximately 34% (n=184) of caregivers have a college diploma or less and nearly 93% (n=499) are married or cohabiting with a partner. Nearly half (n=172, 47%) of the families have an annual household income ≥CAD $100,000 (an average exchange rate of 1 CAD=0.737626 USD applies). Data cleaning and analysis are ongoing as of manuscript publication., Conclusions: Despite public health restrictions from COVID-19, the Family Stress Study was successful in recruiting and using remote data collection to successfully engage families in this study. The results from this study will help identify the direction and relative contributions of the biological and behavioral pathways linking chronic stress and adiposity. These findings will aid in the development of effective interventions designed to modify these pathways and reduce obesity risk in children., Trial Registration: ClinicalTrials.gov NCT05534711; https://clinicaltrials.gov/study/NCT05534711., International Registered Report Identifier (irrid): DERR1-10.2196/48549., (©Shannon M Pare, Elizabeth Gunn, Katherine M Morrison, Alison L Miller, Alison M Duncan, Andrea C Buchholz, David W L Ma, Paul F Tremblay, Lori Ann Vallis, Nicola J Mercer, Jess Haines. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 20.06.2024.)

Adopting a healthy diet remains central for the prevention of obesity. In adults, higher intake of ultra-processed food is associated with a greater risk of overweight and obesity. However, little is known about the degree of food processing and its association with anthropometric measures in families with preschool-aged children, a critical period for the development of dietary patterns. This cross-sectional study included preschool-aged children ( n = 267) between 1.5 and 5 years of age and their parents ( n = 365) from 242 families enrolled in the Guelph Family Health Study. Dietary assessment was completed using ASA24-Canada-2016. Foods and beverages were classified based on their degree of food processing using the NOVA Classification (unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods). Associations between the energy contribution (% kcal) of each NOVA category and anthropometric measures were examined using linear regression models with generalized estimating equations, adjusted for sociodemographic variables. The energy contribution of ultra-processed foods was the highest relative to the other NOVA categories among parents (44.3%) and children (41.3%). The energy contribution of unprocessed or minimally processed foods was 29.1% for parents and 35.3% for children, processed foods was 24.0% for parents and 21.3% for children, and processed culinary ingredients was 2.6% for parents and 2.1% for children. Ultra-processed foods (% kcal) were positively associated with BMI (β = 0.04, 95% CI: 0.01-0.07, P = 0.02), waist circumference (β = 0.11, 95% CI: 0.03-0.18, P = 0.008) and body weight (β = 0.13, 95% CI: 0.03-0.22, P = 0.01) in parents, but not children. Unprocessed foods (% kcal) were negatively associated with waist circumference in parents (β = -0.09, 95% CI: 0.18-0.01, P = 0.03) and children (β = -0.03, 95% CI: 0.05-0.01, P = 0.01), as well as body weight (β = -0.12, 95% CI: 0.23-0.00, P = 0.04) in parents. The degree of food processing primarily influenced anthropometric outcomes in parents. Nevertheless, diets of children were similar, suggesting that such exposure in families may eventually lead to outcomes observed in parents., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ashraf, Duncan, Darlington, Buchholz, Haines and Ma.)

The purpose of this study was to determine the ability of air displacement plethysmography (ADP) to estimate percentage of fat mass (%FM) in African American children. %FM was determined in 21 boys and 13 girls (11.0 +/- 1.4 y, 18.6 +/- 4.2 kg/m(2) [mean +/- SD]) by ADP (using six published densitometric equations) and dual-energy x-ray absorptiometry (DXA). Measures were done within 2 h of one another, in random order. Regardless of equation, %FM(ADP) was significantly correlated with %FM(DXA) (R(2) = 0.67-0.71, all p < 0.001). %FM(ADP) using the equation of Siri (%FM(ADP-Siri) 20.3 +/- 9.0) agreed most closely with %FM(DXA) (20.0 +/- 10.2, difference p = 0.729). Together, surface area artifact and bone mineral content per unit of bone-free fat-free mass accounted for 29% of the variance in the residual between methods. The correlation between %FM(ADP-Siri) and %FM(DXA) was not significant for those <35 kg (n = 10; R(2) = 0.084, p = 0.417). There was a trend toward %FM(ADP-Siri) underestimating %FM(DXA) in girls (-1.46 +/- 3.0%FM; p = 0.103) but not in boys (1.43 +/- 6.4%FM; p = 0.315). Predicted lung volume was 40.1% higher than measured lung volume (p < 0.001). %FM(ADP-Siri) determined using predicted lung volume was 23.5 +/- 8.9, higher than that using measured lung volume (p < 0.001) and higher than %FM(DXA) (p = 0.001). We conclude that in 9- to 14-y-old African American children and provided lung volume is measured, %FM using ADP with Siri's equation approximates that obtained by DXA. Body composition results determined by ADP in children <35 kg should be interpreted with caution.

Objectives: To compare physical activity levels (PALs) of free-living adults with chronic paraplegia with World Health Organization recommendations and to compare energy expenditure between persons with complete vs. incomplete paraplegia., Research Methods and Procedures: Twenty-seven euthyroid adults (17 men and 10 women) with paraplegia (12.5 +/- 9.5 years since onset; 17 with complete lesions and 10 with incomplete lesions) participated in this cross-sectional study. Resting metabolic rate was measured by indirect calorimetry and total daily energy expenditure (TDEE) by heart rate monitoring. PAL was calculated as TDEE/resting metabolic rate. Total body water was measured by deuterium dilution and fat-free mass (FFM) and fat mass (FM) by calculation (FFM = total body water/0.732; FM = weight - FFM). Obesity was defined using the following percentage FM cutoffs: men 18 to 40 years >22% and 41 to 60 years >25%; and women 18 to 40 years >35% and 41 to 60 years >38%., Results: Nineteen subjects (70.4%; 13 men and six women) were obese. Fifteen subjects (56%) engaged in structured physical activity 1.46 +/- 0.85 times during the observation period for a mean of 49.4 +/- 31.0 minutes per session. Despite this, mean PAL of the group was 1.56 +/- 0.34, indicative of limited physical activity. TDEE was 24.6% lower in subjects with complete paraplegia (2072 +/- 505 vs. 2582 +/- 852 kcal/d, p = 0.0372)., Discussion: PAL of the group was low, indicating that persons with paraplegia need to engage in increased frequency, intensity, and/or duration of structured physical activity to achieve a PAL >/=1.75 and, thereby, to offset sedentary activities of daily living.