Purpose: Declines in diet quality are common during young adulthood, which is associated with weight gain and obesity risk. Data indicate young men have poorer diet quality compared to women. These differences could be explained by eating patterns and behaviors, which might also be differentially associated with outcomes in a behavioral weight loss (BWL) program. Objectives were to: 1) examine if young men and women differ in eating behaviors and patterns; and 2) determine whether these behaviors/patterns are associated with weight loss.

Methods: Participants (N=382, 18-25 years, 58% racial/ethnic minority, age=21.9+2.2, BMI=33.5+4.9 kg/m²) were drawn from a technology-based BWL trial targeting young adults. Weight was assessed objectively in-clinic at baseline and 3-months. Participants answered questions related to their eating behaviors (pre-planning, meal preparation, eating away from home, and confidence in cooking; [1=Strongly Disagree, 5=Strongly Agree]) at baseline and 3-months. T-tests were used to examine gender differences in baseline eating behaviors and patterns. GLM examined gender differences in change at 3-months, controlling for treatment arm. Bivariate analysis was used to examine associations between changes in eating-related behaviors and weight change for men and women.

Results: Men had lower baseline scores for meal planning in advance (p=.004) and using a grocery list to shop (p=.000) compared to women. No gender differences in cooking confidence were observed at entry or 3-months (p’s>.05). Men reported greater improvement in controlling food in the home (p=.013) than women. Higher baseline cooking confidence (r=0.17, p=.002) and improvements in thoughtful eating (r=0.30, p=.000) were associated with weight loss at 3-months for both men and women. For men, more cooking at home (r=-0.47, p=.002) and not having someone else prep meals (r=0.39, p=.015) was associated with greater weight loss. For women, not eating 4 hours before sleep was associated with greater weight loss (r=0.16, p=.036).

Conclusions: Findings suggest that cooking confidence and thoughtful eating are associated with weight loss outcomes for both young men and women. However, cooking at home and meal preparation were related to weight loss for men only. Findings can inform intervention targets for BWL programs for young adults.

Purpose: The study purpose was to explore associations between six health outcomes (general health, mental health, obesity, type 2 diabetes, high blood pressure, and heart disease) and one diet quality indicator (fruit and vegetable intake) with cooking abilities and cooking with processed foods.

Methods: Datasets from two Rapid Response Canadian Community Health Surveys (CCHS) on food skills in 2012 and 2013 were stacked. All minors (<18 years old) were excluded, producing an analytic sample of 19,110 adults. Independent logistic regression models were used to test separate associations between each self-reported health and diet outcome with each independent variable (cooking abilities defined as basic, moderate, and advanced and processed food use defined as minimally-, moderately-, and highly-processed), controlling for age, gender, income, marital status, education, employment status, race, and province of residence.

Results: In fully adjusted models, compared to adults with advanced cooking abilities, those with moderate or basic cooking abilities had significantly lower odds of meeting fruit and vegetable recommendations, reporting very good/excellent mental health, and having obesity (all p<0.05). Compared to adults with advanced cooking abilities, adults with moderate cooking abilities had significantly lower odds of having type 2 diabetes (p=0.01). Compared to adults who used minimally-processed foods, those who used moderately- or highly-processed foods had significantly lower odds of meeting fruit and vegetable recommendations, reporting very good/excellent mental and general health (all p<0.05). Compared to adults who used minimally-processed foods, those who used moderately-processed foods had significantly higher odds of having obesity (p=0.01). There were no significant associations between cooking abilities and general health, high blood pressure, or heart disease or between processed food use and type 2 diabetes, high blood pressure, or heart disease.

Conclusions: This exploratory study revealed strong associations between mental health, cooking skills, and processed food, which should be considered in future research on food skills and diet. Results suggest that having strong cooking skills is not always protective against diet-related diseases (i.e., obesity and type 2 diabetes). Overall, findings reinforce the premise that the value of food skills extends beyond mere diet quality to include broader health outcomes. 

Purpose: Evidence-based diet and physical activity guidelines for cancer survivors are designed to reduce toxicity of therapy, improve health outcomes, and promote healthy longevity. The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Recommendations have recently been operationalized to measure compliance, yet these standardized scoring criteria have not been applied to determine change in survivor adherence after intervention nor assessed for associations with cardiovascular health to inform clinical utility. Therefore, the objectives are to define: 1) change in WCRF/AICR Score pre- to post-intervention and maintenance after a combination nutrition and physical activity intervention; and 2) relationships between WCRF/AICR Score and biomarkers of cardiovascular health.

Methods: Cancer survivors with overweight and obesity (n=62) enrolled in a 6-month biobehavioral intervention designed to promote high compliance to evidence-based WCRF/AICR diet and physical activity recommendations. Intervention components included education and skills development, remote nutritional counseling with motivational interviewing, e-technologies, and produce harvesting. A tapered 6-month maintenance phase followed. Clinical and anthropometric assessments were completed using standard protocols at baseline, post-intervention, and post-maintenance. Dietary intakes are defined by 30-day food frequency questionnaires. Minutes of moderate-vigorous physical activity are measured via FitBit. WCRF/AICR Score is calculated following standardized scoring criteria (range 0-7). Changes in score are determined via a linear model with a correlated error structure within subject and a fixed effect for time. The predictive ability of score on cardiovascular biomarkers is assessed using this same modeling approach with the score as an additional fixed effect.

Results: Enrollment mean WCRF/AICR Score was 3.47±1.09. Mean score was increased to 4.37±1.25 at post-intervention (p<0.001). Participants increased adherence to all recommendations. Scores remained elevated at post-maintenance (n=55, p<0.001). Total WCRF/AICR Score was a significant predictor of triglycerides (p=0.023), with a one-point increment in recommendation adherence associated with a 5% decrease in triglycerides. Increases in score likewise trended toward decreases in blood pressure, total cholesterol, and LDL cholesterol.

Conclusions: Participation in a WCRF/AICR diet and physical activity intervention results in significant increases in adherence that are associated with improved cardiovascular health. Feasible, effective, and affordable programs targeting survivors are paramount to promoting recommended lifestyle behaviors to mitigate risks. 

Purpose: Physical activity is critical for preventing and treating Type 2 diabetes (T2D). The rising prevalence and morbidity of T2D necessitate novel approaches to promote physical activity in this population. This study analyzes longitudinal trajectories of change in moderate-to-vigorous physical activity (MVPA) in a positive psychology (PP) and motivational interviewing (MI) intervention using latent growth curve modeling (LGCM). Analyses identified subpopulations within the larger group of participants who responded similarly to the intervention and examined if sociodemographic, medical and psychosocial covariates were associated with MVPA trajectories.

Methods: The BEHOLD-8 and 16-week randomized controlled trials examined the impact of a PP-MI intervention on MVPA in patients with T2D. Objective measures of MVPA were collected using Actigraph accelerometers at three time-points: pre-intervention, immediately following the interventions, and 8 weeks following interventions. LGCM was conducted using the Stata GLLAMM command, and covariates were considered significant at p<0.05.

Results: Analyses included 47 participants with complete follow-ups: 48.9% male, 80.9% non-Hispanic white, average age 66.1 (SD=10.1). LGCM identified three profiles with distinct MVPA trajectories. Profile 1 (“Started Low, No Change”) encompassed 63.8% of participants, with a starting mean of 4.54 minutes of MVPA/day and decreased by -3.36 minutes by the end of follow-up. Profile 2 (“Moderate Start, Minimal Change”) included 27.7% of the participants and had a starting mean of 22.86 minutes/day of MVPA with an average increase of 1.03 minutes over time. Profile 3 (“Started Low, Ended High”) included 8.5% of participants, had a starting mean of 7.33 minutes MVPA/day, and increased by 28.4 minutes over time. Overall, 36% of the participants increased MVPA while 57% did not. Being male, younger, having fewer comorbidities and less anxiety were significantly associated with MVPA.

Conclusions: This secondary analysis detected three distinct physical activity profiles during and after a PP-MI intervention. Future interventions can target individuals with characteristics that showed the greatest benefit and add additional supports to people in groups that did not increase physical activity as much. These findings show a need for targeted and sustained behavior change strategies during and after physical activity interventions.

Purpose: Physical activity (PA) participation has been posited to be associated with positive mental health (MH) and psychological well-being. The suggested MH benefits of PA can be particularly beneficial for immigrants/refugees who encounter various migration stressors that put their MH at risk. Despite the distinctive nature of the PA-MH relationship amongst immigrants, most research in this area focused on a biomedical/kinesiological perspective. Applying a holistic biopsychosocial/biocultural lens, this systematic scoping review aims to examine the relationship between different PA domains and immigrants/refugees’ MH in Western countries.

Methods: Five automated databases (PsycINFO, Medline, Embase, PubMed, and Anthropology Plus) were systematically searched, following PRISMA guidelines, to identify pertinent quantitative and qualitative studies from Europe, Canada, the US, Australia and New Zealand. All age/gender groups were eligible, and no restrictions were made on immigrants/refugees’ home countries.

Results: Forty-nine studies were included in this review. Leisure PA participation was significantly associated with reduced symptoms of depression, post-traumatic stress disorder, psychological distress and anxiety among immigrants via different mechanisms, including improved self-confidence, mastery experiences and staying energized and minimizing risky behaviors. Participation in leisure ethnic sports (e.g. Taekwondo for Korean immigrants) additionally improved immigrants’ MH by enhancing their ethnic identity and mitigating their feelings of loneliness and cultural insecurity. Gender stereotyping and gendered norms in sports limited immigrant women’s movement, triggering feelings of inequality and negatively impacting their MH. Participation in travel and domestic PA was associated with low depression and psychological distress symptoms, with reported pathways involving improved mobility, making time pass and feelings of self-accomplishment. Occupational PA performance was associated with conflicting outcomes, with the type of performed occupation being a significant determinant of immigrants’ MH. Suboptimal MH was significantly and positively associated with low PA engagement, resulting in a vicious cycle of physical inactivity and MH challenges.

Conclusions: Longitudinal and mixed-method studies that utilize holistic biopsychosocial/biocultural frameworks are required to thoroughly understand the links between PA and immigrants’ MH. This will help direct tailored, evidence-based PA interventions and policies that foster PA participation and positive MH outcomes amongst immigrants.

Purpose: Evidence suggests that the manner in which sedentary time is accumulated throughout the day is important for physical health. It remains unknown if the way in which sedentary time is accumulated also relates to emotional health, which is especially important to understand during the transition from childhood to adolescence. We explored the longitudinal and bi-directional associations between sedentary time accumulation metrics (i.e., bout length, bout length distribution, and breaks) and symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD) during the adolescent transition among Los Angeles youth.

Methods: Youth (N=167, 10.1[0.9] years old at baseline, 54.5% female, 59.3% Hispanic, 35.9% overweight/obese at baseline) participated in a 3-year longitudinal study that consisted of 6 assessments of sedentary time, and symptoms of MDD and GAD at 6-month intervals. At each assessment, participants wore waist-worn accelerometers (Actigraph GT3X) for 7 days and completed the Revised Child Anxiety and Depression Scale. Those who had ≥1 days of accelerometer data for ≥2 assessments and self-reported emotional disorder symptom data were included. Separate random intercept cross-lagged panel models (RI-CLPM) estimated the within-person uni-directional and bi-directional associations between the sedentary time accumulation metric variables, and symptoms of MDD and GAD across all temporally adjacent assessments (i.e., assessment 1 to assessment 2, assessment 2 to assessment 3, etc.).

Results/Findings: The RI-CLPMs did not reveal bi-directional associations between any of the study variables. However, within-person uni-directional associations were observed across some assessments. Within-person variation in MDD and GAD symptoms most-consistently predicted sedentary time accumulation. Typically, higher-than-usual MDD or GAD symptoms were associated with longer, less evenly distributed sedentary bouts, and fewer breaks than usual 6 months later, independent of average levels of MDD or GAD symptoms.

Conclusion: Deviations from one’s usual level of depressive or anxiety symptoms, even at subclinical levels, may contribute to the allocation and distribution of sedentary time accumulation 6 months later, but not vice versa. Future studies should attempt to replicate findings and establish causality, as just-in-time adaptive intervention strategies targeting occasions when depressive or anxiety symptoms are higher-than-usual may promote a healthier accumulation of sedentary time among youth.