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Timing and Intensity of Light Correlate with Body Weight in Adults

April 9, 2014 Comments off

Timing and Intensity of Light Correlate with Body Weight in Adults
Source: PLoS ONE

Light exposure can influence sleep and circadian timing, both of which have been shown to influence weight regulation. The goal of this study was to evaluate the relationship between ambient light, sleep and body mass index. Participants included 54 individuals (26 males, mean age 30.6, SD = 11.7 years). Light levels, sleep midpoint and duration were measured with wrist actigraphy (Actiwatch-L) for 7 days. BMI was derived from self-reported height and weight. Caloric intake was determined from 7 days of food logs. For each participant, light and activity data were output in 2 minute epochs, smoothed using a 5 point (10 minute) moving average and then aggregated over 24 hours. The mean light timing above 500 lux (MLiT500) was defined as the average clock time of all aggregated data points above 500 lux. MLiT500 was positively correlated with BMI (r = 0.51, p<0.001), and midpoint of sleep (r = 0.47, p<0.01). In a multivariable linear regression model including MLiT500 and midpoint of sleep, MLiT500 was a significant predictor of BMI (B = 1.26 SE = 0.34, β = 0.53 p = 0.001, r2Δ = 0.22). Adjusting for covariates, MLiT500 remained an independent predictor of BMI (B = 1.28 SE = 0.36, β = 0.54, p = 0.002, r2Δ = 0.20). The full model accounted for 34.7% of the variance in BMI (p = 0.01). Exposure to moderate levels of light at biologically appropriate times can influence weight, independent of sleep timing and duration.

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Unpopular, Overweight, and Socially Inept: Reconsidering the Stereotype of Online Gamers

April 9, 2014 Comments off

Unpopular, Overweight, and Socially Inept: Reconsidering the Stereotype of Online Gamers
Source: Cyberpsychology, Behavior, and Social Networking

Online gaming has become an activity associated with a highly specific, caricatured, and often negative image. This “stereotype” has permeated the collective consciousness, as online gamers have become common caricatures in popular media. A lack of comprehensive demographic inquiries into the online gaming population has made it difficult to dispute these stereotypical characteristics and led to rising concerns about the validity of these stereotypes. The current study aims to clarify the basis of these negative characterizations, and determine whether online video game players display the social, physical, and psychological shortcomings stereotypically attributed them. Sampling and recruiting was conducted using a two-stage approach. First, a representative sample of 50,000 individuals aged 14 and older who were asked about their gaming behavior in an omnibus telephone survey. From this sample, 4,500 video game players were called for a second telephone interview, from which the current data were collected. Only those participants who completed all of the questions relating to video game play were retained for the current analysis (n=2,550). Between- and within-group analyses were enlisted to uncover differences between online, offline, and nongame playing communities across varying degrees of involvement. The results indicate that the stereotype of online gamers is not fully supported empirically. However, a majority of the stereotypical attributes was found to hold a stronger relationship with more involved online players than video game players as a whole, indicating an empirical foundation for the unique stereotypes that have emerged for this particular subgroup of video game players.

Where America is sprawling and what it means

April 2, 2014 Comments off

Where America is sprawling and what it means (PDF)
Source: Smart Growth America

People in compact, connected metropolitan regions are more likely to move up the economic ladder, have lower household costs, enjoy more transportation choices and lead longer, safer, healthier lives according to a new report out today by Smart Growth America and the University of Utah’s Metropolitan Research Center.

Measuring Sprawl 2014 evaluates development in 221 major metropolitan areas in the United States, and ranks these areas based on how sprawling or compact they are. The report also examines how sprawl relates to life in those communities, based on factors like economic mobility, the cost of housing and transportation, life expectancy, obesity, chronic disease and safety.

Dynamic Association of Mortality Hazard with Body Shape

March 3, 2014 Comments off

Dynamic Association of Mortality Hazard with Body Shape
Source: PLoS ONE

Background
A Body Shape Index (ABSI) had been derived from a study of the United States National Health and Nutrition Examination Survey (NHANES) 1999–2004 mortality data to quantify the risk associated with abdominal obesity (as indicated by a wide waist relative to height and body mass index). A national survey with longer follow-up, the British Health and Lifestyle Survey (HALS), provides another opportunity to assess the predictive power for mortality of ABSI. HALS also includes repeat observations, allowing estimation of the implications of changes in ABSI.

Methods and Findings
We evaluate ABSI z score relative to population normals as a predictor of all-cause mortality over 24 years of follow-up to HALS. We found that ABSI is a strong indicator of mortality hazard in this population, with death rates increasing by a factor of 1.13 (95% confidence interval, 1.09–1.16) per standard deviation increase in ABSI and a hazard ratio of 1.61 (1.40–1.86) for those with ABSI in the top 20% of the population compared to those with ABSI in the bottom 20%. Using the NHANES normals to compute ABSI z scores gave similar results to using z scores derived specifically from the HALS sample. ABSI outperformed as a predictor of mortality hazard other measures of abdominal obesity such as waist circumference, waist to height ratio, and waist to hip ratio. Moreover, it was a consistent predictor of mortality hazard over at least 20 years of follow-up. Change in ABSI between two HALS examinations 7 years apart also predicted mortality hazard: individuals with a given initial ABSI who had rising ABSI were at greater risk than those with falling ABSI.

Conclusions
ABSI is a readily computed dynamic indicator of health whose correlation with lifestyle and with other risk factors and health outcomes warrants further investigation.

Disability Status as an Antecedent to Chronic Conditions: National Health Interview Survey, 2006–2012

February 24, 2014 Comments off

Disability Status as an Antecedent to Chronic Conditions: National Health Interview Survey, 2006–2012
Source: Preventing Chronic Disease (CDC)

Introduction
A strong relationship exists between disability and poor health. This relationship could exist as a result of disabilities emerging from chronic conditions; conversely, people with disabilities may be at increased risk of developing chronic conditions. Studying health in relation to age of disability onset can illuminate the extent to which disability may be a risk factor for future poor health.

Methods
We used data from the 2006–2012 National Health Interview Survey and conducted weighted logistic regression analyses to compare chronic conditions in adults with lifelong disabilities (n = 2,619) and adults with no limitations (n = 122,395).

Results
After adjusting for sociodemographic differences, adults with lifelong disabilities had increased odds of having the following chronic conditions compared with adults with no limitations: coronary heart disease (adjusted odds ratio [AOR] = 2.92; 95% confidence interval [CI], 2.33–3.66) cancer (AOR = 1.61; 95% CI, 1.34–1.94), diabetes (AOR = 2.57; 95% CI, 2.10–3.15), obesity (AOR = 1.81; 95% CI, 1.63–2.01), and hypertension (AOR = 2.18; 95% CI, 1.94–2.45). Subpopulations of people with lifelong disabilities (ie, physical, mental, intellectual/developmental, and sensory) experienced similar increased odds for chronic conditions compared with people with no limitations.

Conclusion
Adults with lifelong disabilities were more likely to have chronic conditions than adults with no limitations, indicating that disability likely increases risk of developing poor health. This distinction is critical in understanding how to prevent health risks for people with disabilities. Health promotion efforts that target people living with a disability are needed.

Increasing socioeconomic disparities in adolescent obesity

February 6, 2014 Comments off

Increasing socioeconomic disparities in adolescent obesity
Source: Proceedings of the National Academy of Sciences

Childhood and youth obesity represent significant US public health challenges. Recent findings that the childhood obesity ‘‘epidemic’’ may have slightly abated have been met with relief from health professionals and popular media. However, we document that the overall trend in youth obesity rates masks a significant and growing class gap between youth from upper and lower socioeconomic status (SES) backgrounds. Until 2002, obesity rates increased at similar rates for all adolescents, but since then, obesity has begun to decline among higher SES youth but continued to increase among lower SES youth. These results underscore the need to target public health interventions to disadvantaged youth who remain at risk, as well as to examine how health information circulates through class-biased channels.

How Will More Obesity and Less Smoking Affect Life Expectancy?

January 22, 2014 Comments off

How Will More Obesity and Less Smoking Affect Life Expectancy?
Source: Center for Retirement Research at Boston College

The brief’s key findings are:

  • Obesity is on the rise and smoking is on the decline, so a key issue is the net effect of these two trends on future life expectancy.
  • The analysis examines how each behavior currently affects mortality and applies the results to an estimate of the future prevalence of each behavior.
  • The results show that, in 2040, the benefits of reduced smoking trump the damage from rising obesity.

However, the story differs by gender, with a solid gain for men and only a small improvement for women, who see less of a decline in smoking during the period.

Eligibility for bariatric surgery among adults in England: analysis of a national cross-sectional survey

January 21, 2014 Comments off

Eligibility for bariatric surgery among adults in England: analysis of a national cross-sectional survey
Source: Journal of the Royal Society of Medicine

Objectives:
This study aimed to determine the number eligible for bariatric surgery and their sociodemographic characteristics.

Design:
We used Health Survey for England 2006 data, representative of the non-institutionalized English population.

Setting:
The number of people eligible for bariatric surgery in England based on national guidance is unknown. The UK National Institute for Health and Clinical Excellence criteria for eligibility are those with body mass index (BMI) 35–40 kg/m2 with at least one comorbidity potentially improved by losing weight or a BMI > 40 kg/m2.

Participants:
Of 13,742 adult respondents (≥18 years), we excluded participants with invalid BMI (n = 2103), comorbidities (n = 2187) or sociodemographic variables (n = 27) data, for a final study sample of 9425 participants.

Main outcome measures:
The comorbidities examined were hypertension, type 2 diabetes, stroke, coronary heart disease and osteoarthritis. Sociodemographic variables assessed included age, sex, employment status, highest educational qualification, social class and smoking status.
Results: 5.4% (95% CI 5.0–5.9) of the non-institutionalized adult population in England could meet criteria for having bariatric surgery after accounting for survey weights. Those eligible were more likely than the general population to be women (60.1% vs. 39.9%, p<0.01), retired (22.4% vs. 12.8% p<0.01), and have no formal educational qualifications (35.7% vs. 21.3%, p<0.01).

Conclusions:
The number of adults potentially eligible for bariatric surgery in England (2,147,683 people based on these results and 2006 population estimates) far exceeds previous estimates of eligibility. In view of the sociodemographic characteristics of this group, careful resource allocation is required to ensure equitable access on the basis of need.

Canaries in the coal mine: a cross-species analysis of the plurality of obesity epidemics

December 3, 2013 Comments off

Canaries in the coal mine: a cross-species analysis of the plurality of obesity epidemics
Source: Proceedings of the Royal Society

A dramatic rise in obesity has occurred among humans within the last several decades. Little is known about whether similar increases in obesity have occurred in animals inhabiting human-influenced environments. We examined samples collectively consisting of over 20 000 animals from 24 populations (12 divided separately into males and females) of animals representing eight species living with or around humans in industrialized societies. In all populations, the estimated coefficient for the trend of body weight over time was positive (i.e. increasing). The probability of all trends being in the same direction by chance is 1.2 × 10−7. Surprisingly, we find that over the past several decades, average mid-life body weights have risen among primates and rodents living in research colonies, as well as among feral rodents and domestic dogs and cats. The consistency of these findings among animals living in varying environments, suggests the intriguing possibility that the aetiology of increasing body weight may involve several as-of-yet unidentified and/or poorly understood factors (e.g. viral pathogens, epigenetic factors). This finding may eventually enhance the discovery and fuller elucidation of other factors that have contributed to the recent rise in obesity rates.

Public Agrees on Obesity’s Impact, Not Government’s Role

November 15, 2013 Comments off

Public Agrees on Obesity’s Impact, Not Government’s Role
Source: Pew Research Center for the People & the Press

Most Americans (69%) see obesity as a very serious public health problem, substantially more than the percentages viewing alcohol abuse, cigarette smoking and AIDS in the same terms. In addition, a broad majority believes that obesity is not just a problem that affects individuals: 63% say obesity has consequences for society beyond the personal impact on individuals. Just 31% say it impacts the individuals who are obese but not society more broadly.

Yet, the public has mixed opinions about what, if anything, the government should do about the issue. A 54% majority does not want the government to play a significant role in reducing obesity, while 42% say the government should play a significant role. And while some proposals for reducing obesity draw broad support, others are decidedly unpopular.

New ACC/AHA Prevention Guidelines Address Blood Cholesterol, Obesity, Healthy Living and Risk Assessment

November 13, 2013 Comments off

New ACC/AHA Prevention Guidelines Address Blood Cholesterol, Obesity, Healthy Living and Risk Assessment
Source: American College of Cardiology/American Heart Association

The ACC and the American Heart Association (AHA), in collaboration with the National Heart, Lung, and Blood Institute (NHLBI) and other specialty societies, have released four guidelines focused on the assessment of cardiovascular risk, lifestyle modifications to reduce cardiovascular risk and management of elevated blood cholesterol and body weight in adults.

These four prevention guidelines released Nov. 12 were among five initially commissioned by NHLBI starting in 2008 and transitioned to the ACC and AHA in June 2013 as part of a collaborative arrangement to facilitate their completion and publication. A fifth guideline addressing hypertension will be initiated in early 2014. Each provides important updated guidance for primary care providers, nurses, pharmacists and specialty medicine providers on how best to manage care of individuals at risk for cardiovascular-related diseases based on the latest scientific evidence.

Fighting Obesity in the United States with State Legislation

November 12, 2013 Comments off

Fighting Obesity in the United States with State Legislation
Source: RAND Corporation

Obesity is a problem of epidemic proportions in the U.S. There is a role for government involvement to reduce and prevent this public health problem of obesity. Strategies for obesity prevention are moving away from focusing on the individual alone and towards an ecological model to address environmental and societal influences on behavior. Obesity prevention efforts are taking place at national, state and local levels. Since individual states have fiscal and legislative authority and regulatory powers for public health policy, this project will focus at the state level. Various states have already implemented nutrition standards for school meals, taxes on foods of low nutritional standards, or require weight-related assessments for children and adolescents. Given the need to address ecological factors and the complexities of the policy making process, “Does state legislation reduce and prevent obesity at the state level? If not, why?”

The study’s aims are to: (1) describe the landscape of obesity prevention legislation, including how legislation compares to research-based policy recommendations; (2) examine the association between obesity prevention legislation and obesity prevalence and other weight outcomes; (3) identify the process of how obesity prevention legislation are formulated and implemented, including factors that facilitate or hinder the process; and (4) suggest strategies to improve role of state legislation in preventing obesity.

Ancestral dichlorodiphenyltrichloroethane (DDT) exposure promotes epigenetic transgenerational inheritance of obesity

October 23, 2013 Comments off

Ancestral dichlorodiphenyltrichloroethane (DDT) exposure promotes epigenetic transgenerational inheritance of obesity
Source: BMC Medicine

Background
Ancestral environmental exposures to a variety of environmental factors and toxicants have been shown to promote the epigenetic transgenerational inheritance of adult onset disease. The present work examined the potential transgenerational actions of the insecticide dichlorodiphenyltrichloroethane (DDT) on obesity and associated disease.

Methods
Outbred gestating female rats were transiently exposed to a vehicle control or DDT and the F1 generation offspring bred to generate the F2 generation and F2 generation bred to generate the F3 generation. The F1 and F3 generation control and DDT lineage rats were aged and various pathologies investigated. The F3 generation male sperm were collected to investigate methylation between the control and DDT lineage male sperm.

Results
The F1 generation offspring (directly exposed as a fetus) derived from the F0 generation exposed gestating female rats were not found to develop obesity. The F1 generation DDT lineage animals did develop kidney disease, prostate disease, ovary disease and tumor development as adults. Interestingly, the F3 generation (great grand-offspring) had over 50% of males and females develop obesity. Several transgenerational diseases previously shown to be associated with metabolic syndrome and obesity were observed in the testis, ovary and kidney. The transgenerational transmission of disease was through both female (egg) and male (sperm) germlines. F3 generation sperm epimutations, differential DNA methylation regions (DMR), induced by DDT were identified. A number of the genes associated with the DMR have previously been shown to be associated with obesity.

Conclusions
Observations indicate ancestral exposure to DDT can promote obesity and associated disease transgenerationally. The etiology of disease such as obesity may be in part due to environmentally induced epigenetic transgenerational inheritance.

See: Researchers Link DDT, Obesity (Science Daily)

Prevalence of Obesity Among Adults: United States, 2011–2012

October 18, 2013 Comments off

Prevalence of Obesity Among Adults: United States, 2011–2012
Source: National Center for Health Statistics

Key findings
Data from the National Health and Nutrition Examination Survey, 2011–2012

  • More than one-third (34.9%) of adults were obese in 2011–2012.
  • In 2011–2012, the prevalence of obesity was higher among middle-aged adults (39.5%) than among younger (30.3%) or older (35.4%) adults.
  • The overall prevalence of obesity did not differ between men and women in 2011–2012. Among non-Hispanic black adults, however, 56.6% of women were obese compared with 37.1% of men.
  • In 2011–2012, the prevalence of obesity was higher among non-Hispanic black (47.8%), Hispanic (42.5%), and non-Hispanic white (32.6%) adults than among non-Hispanic Asian adults (10.8%).
  • The prevalence of obesity among adults did not change between 2009–2010 and 2011–2012.

School Lunch Debit Card Payment Systems Are Associated With Lower Nutrition and Higher Calories

October 15, 2013 Comments off

School Lunch Debit Card Payment Systems Are Associated With Lower Nutrition and Higher Calories (PDF)
Source: Obesity

Objective
Debit card payment systems are known to induce more frivolous purchases in adults, but their impact on children is unknown.

Design and Methods
Using a national survey of 2,314 public school students in the United States, food purchases in schools with debit-only systems to those in schools with both debit and cash options are compared.

Results
Students in debit and cash schools purchase more fresh fruit and vegetables and fewer total calories.

Conclusions
Payment systems with cash options have a lower purchase incidence of less healthy foods and higher purchase incidence of more healthy foods.

Pregnancy Weight Gain and Childhood Body Weight: A Within-Family Comparison

October 9, 2013 Comments off

Pregnancy Weight Gain and Childhood Body Weight: A Within-Family Comparison
Source: PLoS Medicine

Background
Excessive pregnancy weight gain is associated with obesity in the offspring, but this relationship may be confounded by genetic and other shared influences. We aimed to examine the association of pregnancy weight gain with body mass index (BMI) in the offspring, using a within-family design to minimize confounding.

Methods and Findings
In this population-based cohort study, we matched records of all live births in Arkansas with state-mandated data on childhood BMI collected in public schools (from August 18, 2003 to June 2, 2011). The cohort included 42,133 women who had more than one singleton pregnancy and their 91,045 offspring. We examined how differences in weight gain that occurred during two or more pregnancies for each woman predicted her children’s BMI and odds ratio (OR) of being overweight or obese (BMI≥85th percentile) at a mean age of 11.9 years, using a within-family design. For every additional kg of pregnancy weight gain, childhood BMI increased by 0.0220 (95% CI 0.0134–0.0306, p<0.0001) and the OR of overweight/obesity increased by 1.007 (CI 1.003–1.012, p = 0.0008). Variations in pregnancy weight gain accounted for a 0.43 kg/m2 difference in childhood BMI. After adjustment for birth weight, the association of pregnancy weight gain with childhood BMI was attenuated but remained statistically significant (0.0143 kg/m2 per kg of pregnancy weight gain, CI 0.0057–0.0229, p = 0.0007).

Conclusions
High pregnancy weight gain is associated with increased body weight of the offspring in childhood, and this effect is only partially mediated through higher birth weight. Translation of these findings to public health obesity prevention requires additional study.

Leveraging Action to Support Dissemination of Pregnancy Weight Gain Guidelines – Workshop Summary

September 29, 2013 Comments off

Leveraging Action to Support Dissemination of Pregnancy Weight Gain Guidelines – Workshop Summary
Source: Institute of Medicine

Along with recommending revised pregnancy weight gain guidelines, the 2009 IOM and National Research Council (NRC) report, Weight Gain During Pregnancy: Reexamining the Guidelines, identified evidence that preconception counseling and certain practices, such as charting weight gain during pregnancy, can lead to improved choices concerning nutrition and physical activity. However, many women still do not receive adequate pre- or post-conception advice about weight and pregnancy weight gain. Many women and health professionals remain unaware of the recommended pregnancy weight guidelines and even those women who are aware of the guidelines may find it difficult to get informed guidance that can help them achieve those guidelines.

On March 1, 2013, the IOM and NRC held a workshop to discuss communication and implementation of recommended guidelines for healthy pregnancy weight gain. The workshop featured a range of products for dissemination, panel discussions on ways to facilitate and support women’s efforts to achieve a healthy weight pre- and post-pregnancy, a discussion on how to put the weight gain guidelines into action, and a presentation on innovative ways to reach women and implement change. This document summarizes the workshop.

Performance Standards for Restaurants: A New Approach to Addressing the Obesity Epidemic

September 6, 2013 Comments off

Performance Standards for Restaurants: A New Approach to Addressing the Obesity Epidemic
Source: RAND Corporation

Americans rely on foods prepared away from home for an estimated 33 percent of caloric intake. Most restaurants serve foods that have excessive calories, fat, sugar, and salt while omitting fruit, vegetables, and whole grains, the very foods needed to meet the Dietary Guidelines for Americans. In an effort to offer guidance to restaurants and communities as they seek to promote healthy food choices, a conference was held on March 14–15, 2012, in Santa Monica, California, that was funded, in part, by the National Institutes of Health/National Institute of Minority Health and Health Disparities and was organized by the RAND Corporation. A group of 38 national experts in nutrition and public health met to develop performance standards that could guide restaurants toward facilitating healthier choices among consumers.

The guidelines are based on the best available science, while also considering feasibility and acceptability. They recommend limiting a single meal to 700 calories or less for adults and 600 calories or less for children. Adult meals should include at least 1.5 cups of fruits or vegetables, less than 10 percent of calories from saturated fat, less than 770 mg of sodium, and less than 35 percent of calories from sugars. Children’s meals should include at least 0.5 cup of fruits or vegetables. Neither meal should include a sugar-sweetened beverage. In addition, the expert panel developed common-sense guidelines discouraging serving practices that increase caloric consumption or undermine a nutritious diet.

Local communities or states could develop and implement certification programs to evaluate adherence to these guidelines on a voluntary or mandatory basis. For example, restaurants could be certified as “healthier” by adopting enough of these guidelines to meet a specified threshold. While offering healthier choices may improve dietary quality, studies are needed to evaluate the economic impact on businesses that adopt them and their effectiveness in reducing caloric intake among diners.

CDC releases 2012 School Health Policies and Practices Study results

August 30, 2013 Comments off

CDC releases 2012 School Health Policies and Practices Study results
Source: Centers for Disease Control and Prevention

School districts nationwide are showing improvements in measures related to nutritional policies, physical education and tobacco policies, according to the 2012 School Health Policies and Practices Study (SHPPS). SHPPS is the largest and most comprehensive survey to assess school health policies.

Key findings include:
Nutrition:

  • The percentage of school districts that allowed soft drink companies to advertise soft drinks on school grounds decreased from 46.6 percent in 2006 to 33.5 percent in 2012.
  • Between 2006 and 2012, the percentage of districts that required schools to prohibit offering junk food in vending machines increased from 29.8 percent to 43.4 percent.
  • Between 2006 and 2012, the percentage of districts with food procurement contracts that addressed nutritional standards for foods that can be purchased separately from the school breakfast or lunch increased from 55.1 percent to 73.5 percent.
  • Between 2000 and 2012, the percentage of districts that made information available to families on the nutrition and caloric content of foods available to students increased from 35.3 percent to 52.7 percent.

Physical education/physical activity:

  • The percentage of school districts that required elementary schools to teach physical education increased from 82.6 percent in 2000 to 93.6 percent in 2012.
  • More than half of school districts (61.6 percent) had a formal agreement, such as a memorandum of agreement or understanding, between the school district and another public or private entity for shared use of school or community property. Among those districts, more than half had agreements with a local youth organization (e.g., the YMCA, Boys or Girls Clubs, or the Boy Scouts or Girl Scouts) or a local parks or recreation department.

Tobacco:

  • The percentage of districts with policies that prohibited all tobacco use during any school-related activity increased from 46.7 percent in 2000 to 67.5 percent in 2012.

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Factors Predicting Physical Activity Among Children With Special Needs

August 28, 2013 Comments off

Factors Predicting Physical Activity Among Children With Special Needs
Source: Preventing Chronic Disease

Introduction
Obesity is especially prevalent among children with special needs. Both lack of physical activity and unhealthful eating are major contributing factors. The objective of our study was to investigate barriers to physical activity among these children.

Methods
We surveyed parents of the 171 children attending Vista Del Mar School in Los Angeles, a nonprofit school serving a socioeconomically diverse group of children with special needs from kindergarten through 12th grade. Parents were asked about their child’s and their own physical activity habits, barriers to their child’s exercise, and demographics. The response rate was 67%. Multivariate logistic regression was used to examine predictors of children being physically active at least 3 hours per week.

Results
Parents reported that 45% of the children were diagnosed with attention deficit hyperactivity disorder, 38% with autism, and 34% with learning disabilities; 47% of children and 56% of parents were physically active less than 3 hours per week. The top barriers to physical activity were reported as child’s lack of interest (43%), lack of developmentally appropriate programs (33%), too many behavioral problems (32%), and parents’ lack of time (29%). However, child’s lack of interest was the only parent-reported barrier independently associated with children’s physical activity. Meanwhile, children whose parents were physically active at least 3 hours per week were 4.2 times as likely to be physically active as children whose parents were less physically active (P = .01).

Conclusion
In this group of students with special needs, children’s physical activity was strongly associated with parental physical activity; parent-reported barriers may have had less direct effect. Further studies should examine the importance of parental physical activity among children with special needs.

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