New parents' sleep, movement, health, and well-being across the postpartum period.

OBJECTIVE: The aim of this study was to examine changes and the bi-directional relationship in sleep and movement, and health and well-being among new parents and differences by sex. METHODS: This secondary data analysis included both conditions from a randomized control trial to improve new parents'physical activity [PA] and recruited couples. Parents (n = 181, 117 couples represented 31.5 ± 4.4 years, 51.3% women, 83.3% White) completed questionnaires on regular overnight sleep duration, PA, mental health (perceived stress), physical health (physical quality of life [PQoL]), and well-being (life satisfaction) at 2-, 4-, 6-, and 8-month postpartum. Random-intercept cross-lagged panel models were stratified by sex to examine changes in sleep and PA with health and well-being across time. RESULTS: Sleep and stress were interrelated at different times for fathers (2 months), and mothers (8 months). Sleep and PQoL improved across time, with mothers reporting less sleep than fathers at 4 and 6 months. PQoL at 4 months was related to MVPA at 6-months. Life satisfaction and PA at 2 months was related to PA at 4 months. CONCLUSION: Mothers and fathers experienced different sleep and stress trajectories. Mental health improved postpartum with early connections to PA. Supporting the 24-hour movement behavior cycle and mental health across the parenthood transition may benefit couples.

Exercise Programming Modelling a Standard of Care Approach Improves Physical Health and Patient-Reported Outcomes in Individuals Living with Breast Cancer: A Pilot Study.

Controlled study designs widely report that exercise improves the health of individuals living with breast cancer. Still, many individuals living with breast cancer are not active enough to experience the benefits of exercise. The Activating Cancer Communities through an Exercise Strategy for Survivors study was developed to reach more individuals living with cancer. This report describes the effects of a 12-week individualized exercise program that models a standard-of-care approach on body composition, physical fitness, and patient-reported outcomes in individuals living with breast cancer. Individuals living with breast cancer were recruited for the study and completed an exercise program twice weekly overseen by a Clinical Exercise Physiologist. A total of 43 participants completed the exercise intervention, and 36 withdrew from the study. All participants had significantly improved aerobic fitness, waist circumference, hip circumference, lower body endurance, physical activity behaviour, health-related quality of life, emotional status, and fatigue levels after completing the program. Flexibility, balance, and sleep scores did not change. The results from the 12-week individualized exercise program largely align with the results from more controlled study designs. These results support future initiatives integrating exercise therapy into the standard of care for individuals living with breast cancer.

Interrupting bedtime to reverse frailty levels in acute care: a study protocol for the Breaking Bad Rest randomized controlled trial.

BACKGROUND: Hospitalized older patients spend most of the waking hours in bed, even if they can walk independently. Excessive bedrest contributes to the development of frailty and worse hospital outcomes. We describe the study protocol for the Breaking Bad Rest Study, a randomized clinical trial aimed to promoting more movement in acute care using a novel device-based approach that could mitigate the impact of too much bedrest on frailty. METHODS: Fifty patients in a geriatric unit will be randomized into an intervention or usual care control group. Both groups will be equipped with an activPAL (a measure of posture) and StepWatch (a measure of step counts) to wear throughout their entire hospital stay to capture their physical activity levels and posture. Frailty will be assessed via a multi-item questionnaire assessing health deficits at admission, weekly for the first month, then monthly thereafter, and at 1-month post-discharge. Secondary measures including geriatric assessments, cognitive function, falls, and hospital re-admissions will be assessed. Mixed models for repeated measures will determine whether daily activity differed between groups, changed over the course of their hospital stay, and impacted frailty levels. DISCUSSION: This randomized clinical trial will add to the evidence base on addressing frailty in older adults in acute care settings through a devices-based movement intervention. The findings of this trial may inform guidelines for limiting time spent sedentary or in bed during a patient's stay in geriatric units, with the intention of scaling up this study model to other acute care sites if successful. TRIAL REGISTRATION: The protocol has been registered at clinicaltrials.gov (identifier: NCT03682523).

Affective Response to Exercise and Affective Judgments as Predictors of Physical Activity Intention and Behavior among New Mothers in their first 6-Months Postpartum.

BACKGROUND: Understanding the predictors of moderate to vigorous physical activity (MVPA) during early postpartum is important to improve promotion efforts. Affect-related constructs are key predictors of MVPA but have limited research in mothers during the postpartum period. PURPOSE: To examine two affect-related constructs (affective response to exercise and affective judgments) as predictors of MVPA intention and behavior across three months, among a sample of new mothers. METHODS: Participants were 105 mothers (M age = 30.64 years; SD = 3.93) who completed measures during postpartum at 2-months post-birth of their first child. The affective response to exercise (assessed at baseline [2-months postpartum] during a submaximal treadmill test), affective judgments and intention (baseline, 6-weeks after baseline), and MVPA (baseline, 6- and 12-weeks after baseline) were assessed via self-report. RESULTS: Path analysis, using ordinary least squares regression, showed that the affective response during exercise was a significant predictor of intention (baseline, 6-weeks), as well as change in intention from baseline to 6-weeks. By contrast, affective judgments predicted intention at 6-weeks, but not at baseline or in the change model. Past MVPA did not moderate these findings, although the affective response during exercise also had a significant indirect effect on MVPA through intention at 6-weeks and 12-weeks. CONCLUSIONS: Interventions targeting women's affective response during exercise may be important during postpartum, perhaps through self-paced physical activity guidance. Affective judgments may not be predictive of MVPA, in part due to unanticipated changes during early postpartum leading to inaccurate expectations of the physical activity experience.

Understanding the predictors of moderate to vigorous physical activity (MVPA) during early postpartum is important to improve promotion efforts. Affect-related constructs are key predictors of MVPA but have limited research in mothers during the postpartum period. The purpose of this study was examine two affect-related constructs (affective response to exercise and affective judgments) as predictors of MVPA intention and behavior across three months, among a sample of new mothers. Participants were 105 mothers who completed measures of affective response to exercise (assessed at 2 months postpartum during a sub-maximal treadmill test), affective judgments and intention (2 months postpartum, and 6-weeks after), and MVPA (2 months postpartum, 6- and 12-weeks after). The affective response during exercise was a significant predictor of intention as well as change in intention over time. By contrast, affective judgments was a less reliable predictor across the study. Interventions targeting women's affective response during exercise may be important during postpartum, perhaps through self-paced physical activity guidance. Affective judgments may not be predictive of MVPA, in part due to unanticipated changes during early postpartum leading to inaccurate expectations of the physical activity experience.

Association of admission frailty and frailty changes during cardiac rehabilitation with 5-year outcomes.

AIMS: Examine the association between (1) admission frailty and (2) frailty changes during cardiac rehabilitation (CR) with 5-year outcomes (i.e. time to mortality, first hospitalization, first emergency department (ED) visit, and number of hospitalizations, hospital days, and ED visits). METHODS AND RESULTS: Data from patients admitted to a 12-week CR programme in Halifax, Nova Scotia, from May 2005 to April 2015 (n = 3371) were analysed. A 25-item frailty index (FI) estimated frailty levels at CR admission and completion. FI improvements were determined by calculating the difference between admission and discharge FI. CR data were linked to administrative health data to examine 5-year outcomes [due to all causes and cardiovascular diseases (CVDs)]. Cox regression, Fine-Gray models, and negative binomial hurdle models were used to determine the association between FI and outcomes. On average, patients were 61.9 (SD: 10.7) years old and 74% were male. Mean admission FI scores were 0.34 (SD: 0.13), which improved by 0.07 (SD: 0.09) by CR completion. Admission FI was associated with time to mortality [HRs/IRRs per 0.01 FI increase: all causes = 1.02(95% CI 1.01,1.04); CVD = 1.03(1.02,1.05)], hospitalization [all causes = 1.02(1.01,1.02); CVD = 1.02(1.01,1.02)], ED visit [all causes = 1.01(1.00,1.01)], and the number of hospitalizations [all causes = 1.02(95% CI 1.01,1.03); CVD = 1.02(1.00,1.04)], hospital days [all causes = 1.01(1.01,1.03)], and ED visits [all causes = 1.02(1.02,1.03)]. FI improvements during CR had a protective effect regarding time to all-cause hospitalization [0.99(0.98,0.99)] but were not associated with other outcomes. CONCLUSION: Frailty status at CR admission was related to long-term adverse outcomes. Frailty improvements during CR were associated with delayed all-cause hospitalization, in which a larger effect was associated with a greater chance of improved outcome.

This work improves our understanding of the relationship between admission frailty and frailty changes with mortality, hospitalization, and emergency department (ED) use in a cardiac rehabilitation (CR) setting. Frailty changes during CR were related with time to hospitalization due to any cause.Higher frailty levels at admission of CR were related to lower time to death, re-hospitalization, and ED visit and to a higher total number of hospitalizations and ED visits due to all causes or due to cardiovascular diseases.Overall, this work underscores the importance of considering the degree of frailty in the CR setting for the purpose of predicting adverse outcomes.

Characterization of Pickering emulsion by SCFAs-modified debranched starch and a potent for delivering encapsulated bioactive compound.

The Pickering emulsion was prepared by short-chain fatty acids (SCFAs) esterified debranched starch. The microstructure, particle size distribution, rheological properties and stability of the emulsions showed that the introduction of acyl groups improved the ability of starch to stabilize the emulsions, in which the butyrylated starch with longer acyl side chains exhibited higher emulsifying ability compared to acetylated and propionylated starches. Pickering emulsions stabilized with butyrylated starch as stabilizer have better stability after 30 days of storage. The particle size distribution of SCFAs-esterified starch emulsions with enzymatic debranching pretreatment was more concentrated and the droplet size was further reduced, which improved the instability factors such as flocculation, agglomeration or Ostwald ripening of emulsions induced by conventional SCFAs-esterified emulsions and further improved the stability of SCFAs-esterified emulsions. More importantly, butyrylated starch (with or without debranched pretreatment) emulsions exhibited smaller and more uniform droplet shapes and higher curcumin encapsulation efficiency (EE%) in SCFAs-esterified starch emulsions, and the EE% of curcumin in debranched butyrylated starch emulsion increasing from 10.04 % in native starch emulsions to 50.70 %.

Gut microbiota derived structural changes of phenolic compounds from colored rice and its corresponding fermentation property.

The influence of phenolic compound extracts from three colored rice cultivars on the gut microbiota was investigated. The results revealed that protocatechuic acid, chlorogenic acid, caffeic acid and p-coumaric acid were the major metabolites after gut microbiota fermentation. The presence of phenolic compounds led to a significantly decreased ratio of Firmicutes and Bacteroidetes, while the abundance of Proteobacteria decreased. At the genus level, phenolic compounds promoted an increase of Prevotella, Megamonas and Bifidobacterium, while the abundance of Bacteroides and Escherichia-Shigella was inhibited. The concentration of ferulic acid and syringic acid was positively correlated with Bifidobacterium, while Megamonas was positively correlated with catechin and caffeic acid. The abundance of Escherichia-Shigella and Citrobacter was found to be significantly negatively correlated with chlorogenic acid. More importantly, this study revealed that the presence of phenolic compounds generated more propionate, followed by acetate, but not butyrate after gut microbiota fermentation.

The influence of sleep and movement on mental health and life satisfaction during the transition to parenthood.

OBJECTIVES: This study assessed whether sleep and physical activity impact mental health and life satisfaction across the transition to parenthood. This study assessed the impact of parenthood on mental health of new parents and parents expecting their second child, and whether change in mental health occurred dyadically across couples. DESIGN: Longitudinal 12-month study. PARTICIPANTS: One hundred and fifty-seven couples (N = 314) between the ages of 25 and 40, who were not expecting to have a child (n = 102), expecting their first child (n = 136), or expecting their second child (n = 76) were recruited. MEASUREMENTS: Participants completed measures at baseline, 6 months, and 12 months. Sleep was assessed with how often participants met sleep guidelines (7-9 hours). Physical activity was measured objectively via accelerometers. Mental health was measured using 6 items from the short form-12 Quality of Life Survey. Life satisfaction was assessed with the Satisfaction with Life Scale (5 items). RESULTS: Mental health was not predicted by physical activity but was predicted by sleep. Sleep at 6 months was positively related to mental health at 6 months (ß = 0.156, p < .001), and sleep at 12 months was positively related to mental health at 12 months (ß = 0.170, p < .001). The change in mental health did not occur dyadically: mental health increased for women but not for men across groups. Mental health was positively related to life satisfaction at 6 months (ß = 0.338, p < .001) and 12-months (ß = 0.277, p < .001). CONCLUSIONS: For new and established parents, getting sufficient sleep plays an important role in mental health and, in turn, life satisfaction.

Prospective study of breakfast frequency and timing and the risk of incident type 2 diabetes in community-dwelling older adults: the Cardiovascular Health Study.

BACKGROUND: No evidence-based recommendations regarding optimal breakfast frequency and timing and type 2 diabetes mellitus (T2DM) exist for older adults because of limited studies. OBJECTIVES: We sought to prospectively assess relations between breakfast frequency and timing and T2DM risk among older adults and determine whether these depended on sex or cardiometabolic risk factors. METHODS: Weekly breakfast frequency and usual daily breakfast time were assessed by questionnaire at baseline in 3747 older adults (aged ≥ 65 y) from the Cardiovascular Health Study (CHS) who were free of cancer and T2DM and followed for 17.6 y. Multivariable-adjusted hazard ratios (aHRs) with 95% CIs estimated from Cox proportional hazards models were used to quantify associations with T2DM. RESULTS: Most CHS participants (median age: 74 y; IQR: 71-78 y) consumed breakfast daily (85.5%), and 73% had their first daily eating occasion between 07:00 and 09:00, both of which were associated with higher socioeconomic status, factors that are indicative of a healthier lifestyle, and lower levels of cardiometabolic risk indicators at baseline. During follow-up, 547 T2DM cases were documented. No strong evidence was observed linking breakfast frequency and risk of T2DM. Compared with participants whose breakfast timing (first eating occasion of the day) was 07:00-09:00, those who broke fast after 09:00 had an aHR for T2DM of 0.71 (95% CI: 0.51, 0.99). This association was present in participants with impaired fasting glucose at baseline (aHR: 0.61; 95% CI: 0.39, 0.95) but not in those without (aHR: 0.83; 95% CI: 0.50, 1.38). No associations between eating frequency or timing and T2DM were observed within other prespecified subgroups. CONCLUSIONS: Eating breakfast daily was not associated with either higher or lower risk of T2DM in this cohort of older adults, whereas a later (after 09:00) daily first eating occasion time was associated with lower T2DM risk in participants with impaired fasting glucose at baseline.This trial was registered at clinicaltrials.gov as NCT00005133.

Pulse flaking: Opportunities and challenges, a review.

Pulses provide economic and health benefits to people in many countries around the world; however, their adoption in western diets, particularly in processed and formulated foods, is limited. One strategy to increase the level of pulses in western diets is to improve pulse accessibility to the ready-to-eat (RTE) food market sector. Pulses have compositional and structural differences when compared to cereals and behave differently during processing. While there have been numerous studies on pulses processed using traditional processing methods, there are limited studies describing processing of pulses as a major ingredient in RTE forms such as flakes. To understand the full processing potential of pulses, systematic studies are required using commercial-scale RTE pilot processing equipment coupled with fundamental property determination techniques to evaluate the effects of processing and pulse material on pulse flake attributes. In-depth studies of pulse properties and their processability are likely to result in the production of high-quality pulse-based foods with superior health benefits. This review explores the current and potential opportunities for processing pulses with a focus on flake products. The roles of pulse type and major structure-forming components such as fiber, carbohydrates, and proteins on end-product quality of processed pulses are discussed.

Program of Rehabilitative Exercise and Education to Avert Vascular Events After Non-Disabling Stroke or Transient Ischemic Attack (PREVENT Trial): A Randomized Controlled Trial.

BACKGROUND: Non-disabling stroke (NDS) and transient ischemic attack (TIA) herald the possibility of future, more debilitating vascular events. Evidence is conflicting about potency of exercise and education in reducing risk factors for second stroke. METHODS: Three-site, single-blinded, randomized controlled trial with 184 participants <3 months of NDS or TIA (mean age, 65 years; 66% male) randomized to usual care (UC) or UC + 12-week program of exercise and education (PREVENT). Primary (resting systolic blood pressure) and secondary outcomes (diastolic blood pressure [DBPrest], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], total cholesterol [TC], TC/HDL, triglycerides, fasting glucose, and body mass index) were assessed at baseline, post-intervention, and 6- and 12-month follow-up. Peak oxygen consumption (VO2peak) was measured at baseline, post-intervention, 12-month assessments. RESULTS: Significant between-group differences at post-intervention favored PREVENT group over UC: DBPrest (mean difference [MD]: -3.2 mmHg, 95% confidence interval [CI]: -6.3, -.2, P = .04) and LDL-C (MD: -.31 mmol/L, 95% CI: -.42, -.20, P = .02). Trends of improvement in PREVENT group were noted in several variables between baseline and 6-month follow-up but not sustained at 12-month follow-up. Of note, VO2 peak did not change over time in either group. CONCLUSION: Impact of PREVENT on vascular risk factor reduction was more modest than anticipated, possibly because several outcome variables approximated normative values at baseline and training intensity may have been sub-optimal. Further investigation is warranted to determine when exercise and education programs are viable adjuncts to pharmaceutical management for reduction of risk factors for second stroke.Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: #NCT00885456.

Predicting the physical activity of new parents who participated in a physical activity intervention.

RATIONALE: The demands of early parenthood may limit the pursuit of moderate-to-vigorous intensity physical activity (MVPA); thus, understanding the predictors of MVPA among this population could help build targeted intervention programs. OBJECTIVE: The purpose of this study was to examine the correlates of MVPA, in the form of constructs subsumed within the theory of planned behavior (TPB) and multi-process action control (M-PAC) framework, among new parents participating in in a couple-based PA promotion randomized trial across a six-month period in the first year after birth. METHODS: In total, 264 participants (132 couples) at the two-month point of parenting their first child were enrolled in the trial through advertisements. MVPA, TPB, and M-PAC constructs were assessed via self-report at baseline, and six-week, three-month, and six-month after baseline time-periods. RESULTS: Dyadic path modeling of the TPB showed that intention only predicted MVPA for mothers and PBC did not predict MVPA. Most of the sample had intentions to be physically active, although the extent to which intentions predicted subsequent MVPA was dependent on mothers and fathers reported strength of planning, habits, and exercise identity (M-PAC variables). Intention was subsequently predicted by affective attitude and PBC for mothers and fathers. CONCLUSIONS: Interventions targeting affective attitude and perceived behavioral control may assist in improving MVPA intentions of new parents; yet, additional intervention strategies to increase planning, habit, and especially exercise identity seems warranted for many parents to close the gap between intention and PA. The findings highlight the complementary approach of intention formation and intention translation theories among new parents.

Couple-Based Physical Activity Planning for New Parents: A Randomized Trial.

INTRODUCTION: The demands of parenthood may limit the pursuit of moderate-to-vigorous intensity physical activity (MVPA), establish inactivity patterns into middle age, and lead to long-term poorer health and well-being. The purpose of this study was to examine the efficacy of a couple-based planning skills intervention to support MVPA from baseline (~2 months after birth) up to 6 months later in first-time parents. STUDY DESIGN: Randomized trial. PARTICIPANTS: 264 parents (132 couples) at the 2-month point of parenting their first child. INTERVENTION: Couples were randomized to either an education control (n=58 couples) or an education plus planning condition (n=74 couples). MAIN OUTCOME MEASURES: MVPA was assessed via accelerometry and self-report at baseline, 6 weeks, 3 months, and 6 months. Health-related fitness (aerobic fitness, muscular strength, flexibility) and BMI tests were conducted at baseline and 6 months. Rolling recruitment was between 2014 and 2017. RESULTS: The accelerometry results had large amounts of missing data that were not missing at random, so only self-reported MVPA was analyzed. Dyadic multilevel modeling conducted in 2020 showed that mothers' MVPA had a significant quadratic pattern over time that was similar for both conditions, and BMI decreased while strength and flexibility increased. Fathers did not have significant outcomes. Participants who were not meeting MVPA guidelines at baseline responded to the education plus planning condition with increased MVPA (father B=1.31, mother B=1.14, p<0.05) compared with those who initially met those guidelines. CONCLUSIONS: Mothers may be more responsive than fathers to MVPA interventions in early parenthood. Already active parents likely have little to be gained from additional intervention. Future research is needed to effectively promote MVPA during fatherhood and identify novel ways to sustain PA past the early response to an intervention. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT02290808.

Physicochemical characterisation of kafirins extracted from sorghum grain and dried distillers grain with solubles related to their biomaterial functionality.

Kafirin, the hydrophobic prolamin storage protein in sorghum grain is enriched when the grain is used for bioethanol production to give dried distillers grain with solubles (DGGS) as a by-product. There is great interest in DDGS kafirin as a new source for biomaterials. There is however a lack of fundamental understanding of how the physicochemical properties of DDGS kafirin having been exposed to the high temperature conditions during ethanol production, compare to kafirin made directly from the grain. An understanding of these properties is required to catalyse the utilisation of DDGS kafirin for biomaterial applications. The aim of this study was to extract kafirin directly from sorghum grain and from DDGS derived from the same grain and, then perform a comparative investigation of the physicochemical properties of these kafirins in terms of: polypeptide profile by sodium-dodecyl sulphate polyacrylamide gel electrophoresis; secondary structure by Fourier transform infra-red spectroscopy and x-ray diffraction, self-assembly behaviour by small-angle x-ray scattering, surface morphology by scanning electron microscopy and surface chemical properties by energy dispersive x-ray spectroscopy. DDGS kafirin was found to have very similar polypeptide profile as grain kafirin but contained altered secondary structure with increased levels of ß-sheets. The structure morphology showed surface fractals and surface elemental composition suggesting enhanced reactivity with possibility to endow interfacial wettability. These properties of DDGS kafirin may provide it with unique functionality and thus open up opportunities for it to be used as a novel food grade biomaterial.

Manipulations of glucose/lipid metabolism and gut microbiota of resistant starch encapsulated Ganoderma lucidum spores in T2DM rats.

Our team previously demonstrated that Ganoderma lucidum spores (GLS) and resistant starch (RS) had hypoglycemic effects separately on type 2 diabetic mellitus (T2DM) rats. This work was to explore the effects of administering encapsulated GLS within RS (referred to as EGLS) in the T2DM rats, which were induced by streptozotocin (STZ). The EGLS was orally administered to rats for 28 days. The parameters of glycometabolism and lipometabolism were evaluated, and fecal microbiota composition was investigated. The results showed that EGLS significantly enhanced glycometabolism and lipometabolism parameters in T2DM rats, which might be associate with the enhancement of the glucose and lipid metabolism, insulin secretion, and glycogen synthesis and reduced lipogenesis. Furthermore, the intervention of EGLS also reduced the Proteobacteria community and improved dysfunctional gut microbiota. This study indicated EGLS may be a potential candidate for dietary intervention to modulate diabetes.

Characterizing the volatile compounds of different sorghum cultivars by both GC-MS and HS-GC-IMS.

The current study applied both GC-MS and GC-IMS for characterizing the volatile compounds of six Australian sorghum cultivars. For raw sorghum, the result of GC-MS showed that the ester compounds were abundant in six raw samples. Among these esters, the content of hexadecanoic acid ethyl ester was highest in all of the raw samples. Compound 3-octanone only existed in Apollo, Bazley and Liberty, and 2-undecanone was found to be in MR43. The result of GC-IMS showed that the signals of benzaldehyde, 2,3-butanedione were generally noted in the six raw samples. In general, The Apollo and Buster had more volatile compounds, followed by Bazley and Liberty. In contrast, MR43 and G44 had the least volatile compounds. For cooked sorghums, more fatty aldehydes are formed compared to its corresponding raw sample, in which the current data indicated that 40 volatile compounds were identified by GC-MS, and 11 of them were identified as the key aroma compounds (OAVs > 1). More important, the variation in the compounds of hexanal, heptanal, octanal, 2-heptenal, nonanal, trans- 2-octenal, benzeneaceldehyde, (E)-2-nonenal, 1-octen-3-ol, 1-pentanol, 2-methoxy-4-vinylphenol and 2-pentylfuran might be applied for explaining the aroma characteristics among the six sorghum cultivars. The result of GC-IMS showed that 26 volatile compounds but not in the results from GC-MS detection, indicating the advantage of the methodology combination for a better understanding the impact of cultivars and cooking on volatile characteristics of the sorghums.

Predicting Family and Child Physical Activity across Six-Months of a Family-Based Intervention: An Application of Theory of Planned Behaviour, Planning and Habit.

Family-based physical activity (PA) interventions have proven effective in modifying PA; yet, the underlying mechanisms are currently unclear. In this study, we follow-up upon prior trial data that showed changes to child moderate-to-vigorous PA (MVPA) as a result of a family education+planning intervention compared to an education-only condition. We examined parents' perceived family PA frequency, family PA social cognitions, and family PA habit over 26 weeks between the two conditions. One hundred and two parents (of children aged 6 to 12 yrs), were recruited through advertisements and randomized to either the planning + education condition (n = 52) or an education-only condition (n = 50). Self-reported family PA, and measures of theory of planned behaviour, planning intention, and habit were completed by the contact parent at baseline, six-week, 13-week, and 26-week time-periods. The education+planning intervention increased planning intention (p <.01) and family PA (p =.06) compared to the© education-only group. The effect of condition on the putative mediators did not explain these changes (all 95% CIs crossed 0), and family PA was associated with child MVPA only at 13 weeks (p <.01). Intervention 20 assignment had a small indirect effect on family PA (favouring©the education+planning group) via Habit. Perceived behavioural©control and habit were consistent predictors of family PA (p <.05), but not PA intention or planning intention (p >.05). The planning+education intervention showed improved family PA and planning intention, yet null mediation results suggest that other variables from the family system (e.g., child motivation, other parent's motivation and plans) are likely needed to fully understand the intervention effects. The promotion of perceived behavioural control and habit to assist in family PA is recommended for future research in this population.

Prospective Study of Skipping Meals to Lose Weight as a Predictor of Incident Type 2 Diabetes With Potential Modification by Cardiometabolic Risk Factors: The Canadian 1995 Nova Scotia Health Survey.

BACKGROUND: Skipping meals is an increasingly common practice to lose weight among North American adults. However, the long-term effect of this practice on incident type 2 diabetes mellitus (T2DM) remains unknown. We assessed whether skipping meals to lose weight is associated with T2DM risk and whether this association is modified by cardiometabolic risk factors. METHODS: Skipping meals to lose weight was assessed by questionnaire in 2,288 adults from the 1995 Nova Scotia Health Survey and was linked to administrative health databases to determine T2DM incidence in the following 23 years. Multivariable-adjusted Cox proportional hazards models estimated hazard ratios (aHRs) and 95% confidence intervals (CIs) for T2DM. RESULTS: During follow up, 378 T2DM cases were diagnosed. Compared with participants who did not skip meals to lose weight, those who did (2.2%) had a 125% higher risk of T2DM (aHR, 2.25; 95% CI, 1.31 to 3.86). This association was no longer present after further adjustment for baseline body mass index (BMI) (aHR, 1.66; 95% CI, 0.96 to 2.85). Skipping meals to lose weight was associated with T2DM among participants who were men (n=1,135; aHR, 2.09; 95% CI, 1.09 to 4.02) or had a BMI <30 kg/m2 (n=1,676; aHR, 2.64, 95% CI, 1.15 to 6.06), elevated cholesterol (n=1,146; aHR, 2.11; 95% CI, 1.06 to 4.22), high blood pressure (n=1,133; aHR, 2.10; 95% CI, 1.10 to 4.01) and restless sleep (n=1,186; aHR, 2.19; 95% CI, 1.13 to 4.25), but not among women, those with a BMI of ≥30 kg/m2 and those without elevated cholesterol, high blood pressure or restless sleep. CONCLUSIONS: Skipping meals to lose weight may be a predictive modifiable risk factor for developing T2DM over time, potentially working in connection with other T2DM risk factors.

Location-Based Sedentary Time and Physical Activity in People Living With Coronary Artery Disease.

PURPOSE: Sedentary time (ST) and lack of physical activity increase the risk of adverse outcomes for those living with coronary artery disease (CAD). Little is known about how much ST, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) that CAD participants not attending cardiac rehabilitation engage in, the locations where they engage in these behaviors, and how far from home the locations are. METHODS: Participants completed a survey and wore an accelerometer and global positioning system receiver for 7 d at baseline and 6 mo later. RESULTS: Accelerometer analyses (n = 318) showed that participants averaged 468.4 ± 102.7 of ST, 316.1 ± 86.5 of LPA, and 32.9 ± 28.9 of MVPA min/d at baseline. ST and LPA remained stable at 6 mo, whereas MVPA significantly declined. The global positioning system (GPS) analyses (n = 315) showed that most of participant ST, LPA, and MVPA time was spent at home followed by other residential, retail/hospitality, and work locations at baseline and 6 mo. When not at home, the average distance to a given location ranged from approximately 9 to 18 km. CONCLUSIONS: Participants with CAD spent the majority of their time being sedentary. Home was the location used the most to engage in ST, LPA, and MVPA. When not home, ST, LPA, and MVPA were distributed across a variety of locations. The average distance from home to a given location suggests that proximity to home may not be a barrier from an intervention perspective.