The relationship between physical activity, stress, and resilience in sexual and gender minority college students.

OBJECTIVE: To assess the role of sexual orientation and gender identity in the relationship between physical activity (PA), stress and resilience. PARTICIPANTS: A nationally-representative sample of students (n = 91,718) from United States postsecondary institutions. METHODS: Students reported aerobic and strength training (ST) behaviors, stress, resilience, gender identity and sexual orientation. Moderated regressions examined the influence of gender identity and sexual orientation on the relationship between PA and stress or resilience. RESULTS: Men and heterosexual students reported higher PA and resilience and lower stress than did women, gender minorities, and sexual minorities. Significant moderation was found for women, queer students, bisexual students, trans women and lesbians in the various models. CONCLUSIONS: Gender minority and sexual minority students display poorer levels of PA and mental health than cisgender and heterosexual counterparts, but this relationship varies by identity group.

Effectiveness of obesity interventions among South Korean children and adolescents and importance of the type of intervention component: a meta-analysis.

BACKGROUND: Various interventions have been tested to prevent or treat childhood obesity in South Korea. However, the overall effect of those interventions is unclear, as very few reviews and meta-analyses were specific to Korean children and adolescents. PURPOSE: We aimed to examine the overall effect of obesity interventions among Korean children and adolescents, while also examining differences by sex, age group, baseline weight category, intervention duration, number of intervention components, and type of intervention components. METHODS: A meta-analysis was conducted for all intervention studies sampling Korean children and adolescents, with at least one control group and one month of follow-up, published between January 2000 and August 2020. Cohen d was calculated as an effect size for treatment effect, using the standardized difference between intervention group's body mass index (BMI) change and control group's BMI change. RESULTS: The final sample included 19 intervention studies with 2,140 Korean children (mean age, 12.2 years). Overall, interventions were strongly favored over their controls (d=1.61; 95% confidence interval [CI], 1.12-2.09). The subgroup analysis showed that interventions with at least one physical activity component (d=2.43; 95% CI, 1.63-3.24) were significantly better than those that did not include physical activity (d=0.02; 95% CI, -0.26 to 0.31). CONCLUSION: Type of intervention component appeared important, though no differential association was observed by sex, age, baseline weight category, intervention duration, and number of intervention components. Korean and non-Korean interventions may be substantively different. Additional studies are needed to understand why and how Korean interventions differ from non-Korean interventions.

Prevalence and correlates of highly caffeinated beverage consumption among Korean adolescents.

OBJECTIVE: The purposes of this study were to (1) examine the multi-year prevalence of highly caffeinated beverage (HCB) consumption, (2) identify sex differences in the prevalence, and (3) investigate relationships between HCB consumption and behavioral characteristics in a nationally representative sample of Korean adolescents. METHODS: Data from the Korea Youth Risk Behavior Web-based Survey (2014-2017) were analyzed. RESULTS: HCB consumption was higher in 2017 than 2014 (23.9% vs. 12.0%), and higher among boys than girls (17.2% vs. 13.1%). HCB drinkers were more likely to (1) be boys, (2) be overweight or obese, (3) use alcohol and tobacco, (4) consume soda at least once per week, (5) consume sweetened beverages at least once per week, (6) have seriously considered suicide during the past 12 months, and (7) have attempted suicide during the past 12 months (p<0.05 for all). CONCLUSION: Effective programs to curb HCB consumption among Korean adolescents need to be established.

Sex differences in weight perception and weight gain among Black college students in the USA.

OBJECTIVE: The aims of this study were to examine the prevalence of overweight/obesity and to explore sex differences in body weight perceptions and correlates of weight gain among Black students at 2 historically Black colleges and universities (HBCUs) in the USA. METHODS: Participants completed a paper-based survey, and their height and weight were measured (67% completion rate). RESULTS: The overweight and obesity rates were 33.8% and 26.9%, respectively. More females than males accurately assessed their weight (p < 0.05). Body weight underestimation was associated with male sex, excellent/very good perceived overall health, and not being informed by a doctor of having overweight or obesity (p < 0.01). Higher odds of ≥5% weight gain were related to female sex, living on campus, and not being informed by a doctor of having overweight or obesity (p < 0.05). CONCLUSION: Given the high overweight and obesity rates among Black students, HBCUs in the USA should develop intervention strategies for the prevention and management of overweight and obesity. College health educators at HBCUs need to provide regular check-ups or health screenings that help male students perceive their weight accurately and prevent weight underestimation. It is important for HBCUs to monitor and address weight gain among Black students as early as possible.

Sex and racial/ethnic differences in the prevalence of overweight and obesity among U.S. college students, 2011-2015.

OBJECTIVE: To investigate sex and racial/ethnic differences in overweight and obesity in college students. Participants: A nationally representative sample of 319,342 U.S. college students (mean age = 20.4 years; 67.7% female) from Fall 2011 to Spring 2015. Methods: A secondary data analysis of multi-year cross-sectional data was performed. Multiple logistic regression was used to examine factors (e.g. cumulative grade average, year in school, and living place) associated with overweight and obesity determined from BMI calculated by self-reported height and weight. Results: The prevalence of overweight and obesity was significantly higher for both sexes in Spring 2015 than in Fall 2011. Significant differences were found in overweight and obesity by sex and race/ethnicity. Higher adjusted odds ratios for overweight and obesity were observed for men, blacks, and Hispanics (compared to whites). Asians had the lowest adjusted odds of overweight and obesity. Conclusions: Intervention strategies for the prevention and management of overweight and obesity in U.S. college students should consider sex and racial/ethnic inequalities.

Regional disparities in healthy eating and nutritional status in South Korea: Korea National Health and Nutrition Examination Survey 2017.

BACKGROUND/OBJECTIVES: Concerns about regional disparities in heathy eating and nutritional status among South Korean adults are increasing. This study aims to identify the magnitude of regional disparities in diet and nutritional status among Korean adults who completed the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: The participants were a nationally representative sample of Korean adults aged 19 years and older from the 2017 KNHANES (n = 6,126). We employed the svy commands in STATA to accommodate the complex survey design. The relative concentration index (RCI), absolute concentration index (ACI) and index of disparity were used to measure regional nutritional inequalities. RESULTS: Overweight and obese adults were more prevalent among the poor than among the rich in urban areas (RCI = -0.041; P < 0.05), while overweight and obese adults were more prevalent among the rich than among the poor in rural areas of South Korea (RCI = 0.084; P < 0.05). Economic inequality in fruit and vegetable intake ≥ 500 g per day was greater in rural areas than in urban areas in both relative size (RCI = 0.228 vs. 0.091, difference in equality = 0.137; P < 0.05) and absolute size (ACI = 0.055 vs. 0.023, difference in equality = 0.032; P < 0.05). CONCLUSIONS: This study provides useful information identifying opposite directions in the relative concentration curves between urban and rural areas. Adult overweight/obesity was more prevalent among the poor in urban areas, while adult overweight/obesity was more prevalent among the rich in rural areas. Public health nutrition systems should be implemented to identify nutritional inequalities that should be targeted across regions in South Korea.

Sex and Racial/Ethnic Differences in Suicidal Consideration and Suicide Attempts among US College Students, 2011-2015.

Objectives: In this study, we examined sex and racial/ethnic differences in the prevalence and predictors of suicide consideration and attempts among US college students. Methods: We used multivariable logistic regression to investigate suicide consideration and attempts by sex and race/ethnicity among students (N = 319,342) who completed the American College Health Association-National College Health Assessment from fall 2011 to spring 2015. Results: Overall, the prevalence of suicide consideration and attempts was higher in spring 2015 than fall 2011 (p < .05). Men had higher odds of suicide consideration and attempts than women (p < .001). Blacks, Hispanics, and Asians had higher odds of suicide consideration and attempts compared with Whites (p < .001). Weight-related problems (unhealthy weight, body weight overestimation, and lack of physical activity), sleep problems (insufficient sleep and sleep difficulties), and lower levels of academic performance were associated with both suicide consideration and attempts (p < .05). Conclusions: Our findings indicate a need for sex- and race/ethnicity-specific suicide prevention strategies for college students, specifically men and racial/ethnic minority groups. Furthermore, appropriate weight and sleep management could be considered to help prevent suicide among US college students.

Relationship between sleep and obesity among U.S. and South Korean college students.

BACKGROUND: Little is known about the relationship between sleep and obesity in young adults, particularly college students. This study examined the relationship between sleep (i.e., sleep duration and quality) and obesity in a large and diverse binational sample of college students. METHODS: Analyses were based on a 40-item paper survey from 2016/2017 to 2017/2018 academic years, with a 72% response rate. The samples were 1578 college students aged 18-25 years from five universities (two in the U.S. and three in South Korea). Weight and height were measured objectively; other measures (e.g., health behaviors) were self-reported. Multinomial logistic regression was used to assess the association between sleep duration and independent variables (race/nationality, gender, and BMI). Poisson regression was used to examine the relationship between sleep quality and independent variables. RESULTS: Overall, blacks had a higher adjusted odds ratio (AOR) of short sleep (< 7 h/night) than whites (AOR = 1.74, P < .01); overweight participants had a higher AOR of short sleep than normal weight participants (AOR = 1.52, P < .01); and obese participants had a higher AORs of both short and long sleep (> 9 h/night) (AOR = 1.67, P < .01; AOR = 1.79, P < .05, respectively). Among men, being black, overweight, and obesity were associated with short sleep (P < .05), whereas only obesity was related to short sleep among women (P < .05). In analyses stratified by race and nationality, overweight and obesity were related to short sleep among blacks only (P < .05). Overall, sleep quality (getting enough sleep to feel rested in the morning in the past 7 days) was worse in blacks and South Koreans than whites (P < .05), worse in women than men (P < .05), and worse in participants with obesity than normal weight participants (P < .05). CONCLUSIONS: Obesity was associated with both short (< 7 h/night) and long sleep duration (> 9 h/night) and poor sleep quality among all participants. In comparison with whites, blacks were more like to have short sleep, and blacks and South Koreans had worse sleep quality. Further investigations using a larger sample of college students in multiple countries may be helpful to identify target populations who are at a greater risk of obesity and sleep problems.

Sex and racial/ethnic differences in sleep quality and its relationship with body weight status among US college students.

Objective: To examine sex and racial/ethnic differences in sleep quality and the association between sleep quality and body weight status among US college students. Participants: A nationally representative sample (N = 324,767) of college students from 2011 to 2015. Methods: A secondary data analysis of cross-sectional data. Results: Women showed poorer sleep quality (nights per week getting enough sleep to feel rested) than men (4.00 versus 4.34 days; p < .001). In both men and women, compared with non-Hispanic whites, racial/ethnic minorities showed lower sleep quality (p < .001). Compared with normal weight participants, overweight participants had poorer sleep quality (p = .007) among men, and both overweight (p = .004) and obese participants (p < .001) had lower sleep quality among women. Conclusions: Understanding sex and racial/ethnic sleep differences and the association between sleep and body weight status is important for colleges to promote college students' healthy sleep.

Gender and Racial/Ethnic Differences in the Association Between Alcohol Drinking Patterns and Body Mass Index-the National Health and Nutrition Examination Survey, 1999-2010.

BACKGROUND: Racial/ethnic variations in both alcohol consumption and obesity prevalence are well established. However, previous research indicates that drinking patterns influence the relation of alcohol intake to body mass index (BMI), and information on racial/ethnic differences in the relation of drinking pattern to BMI is lacking. METHODS: Multi-year cross-sectional data extracted from the 1999-2010 National Health and Nutrition Examination Survey for adults ≥ 20 years (N = 25,816) were used. Effects of drinking patterns were analyzed using a linear dose-response model that considered the joint effects of frequency (number of days in the past year that at least one drink was consumed) and dosage (the number of drinks consumed in excess of the first drink on days when more than one drink was consumed). RESULTS: For all racial/ethnic groups except Mexican Americans, current drinkers had a lower mean BMI than non-drinkers. Mean BMI differences were - 0.721 kg/m2 for non-Hispanic white (white) men and - 1.292 kg/m2 for white women. Among drinkers, drinking frequency was negatively associated with BMI for all racial/ethnic groups; however, this effect was significantly smaller for Mexican American men and other Hispanic men than white men. Dosage was positively associated with BMI among all racial/ethnic groups except Mexican American women and other Hispanic women; this effect was significantly stronger among black women than white women. CONCLUSION: Gender and racial/ethnic differences in the relation of drinking patterns to BMI should be taken into consideration when investigating factors that influence the effect of alcohol consumption on BMI.

Racial/ethnic differences in body weight perception among U.S. college students.

OBJECTIVE: To examine racial/ethnic differences in weight perception by sex among U.S. college students. PARTICIPANTS: a national sample (N = 70,267) of college students selected from 2- and 4-year postsecondary institutions (N = 62) during the Fall semester from 2011 to 2014. METHODS: This is a secondary data analysis using 4 years of American College Health Association-National College Health Assessment IIb data. Sex-stratified multinomial logistic regression was performed to investigate racial/ethnic differences in body weight perception. RESULTS: Compared with non-Hispanic whites, non-Hispanic black men and women were more likely to underestimate their body weight (p < .01). Asian men and women were more likely to overestimate their body weight than non-Hispanic whites (p < .001). CONCLUSIONS: Weight-related interventions should take into account racial/ethnic differences in body weight perception.

Overweight and Physical Inactivity Among African American Students at a Historically Black University.

BACKGROUND: Little is known about correlates of overweight, obesity, and physical inactivity among African American students at historically Black colleges and universities. OBJECTIVE: To assess overweight, obesity, and physical inactivity among African American college students at a historically Black university in Maryland in the USA. METHODS: Data were collected from 268 African American college students in 2013. Data were analyzed with percentage difference z-tests, chi-square tests, and multiple logistic regression. DESIGN: Cross-sectional survey (student response rate = 49.9%). RESULTS: The overweight/obesity rate of participants was 47.5%, which was higher than that of the U.S. college student population overall (34.1%) and a representative sample of African American college students (38.3%). When age and sex were controlled, a family history of obesity, skipping breakfast, drinking caffeinated drinks, lower family income, and smoking a pipe, cigars, or cigarettes daily were significant correlates of overweight (obesity included). The percentage of physical inactivity was 68.3, and physical inactivity was higher among women and overweight or obese students. CONCLUSION: Given the high overweight and obesity prevalence among African American college students, historically Black colleges and universities in the USA should increase health promotion efforts targeting weight-related behaviors, particularly physical activity.

Cigarette smoking among Korean international college students in the United States.

OBJECTIVE AND PARTICIPANTS: This study explored (1) the prevalence of cigarette smoking among South Korean international college students in the United States, (2) differences in smoking between on- and off-campus living arrangements, and (3) predictors of an increase in smoking over time in the United States METHODS: An online survey was completed by 1,201 students at 52 4-year US universities (34% response rate). RESULTS: The overall smoking prevalence was 43.5%. The smoking rate (29.0%) of female students was higher than that (4%) of female college students in South Korea. Sex, living place, living situation, length of stay as a student in the United States, home smoking rules, campus-wide tobacco-free policies, and levels of acculturative stress, anxiety, and depression were significantly associated with an increase in smoking (p < .05). CONCLUSIONS: Given the high smoking prevalence among the South Korean students on US college campuses, targeted prevention efforts for these students may be warranted.

A meta-analysis of obesity interventions among U.S. minority children.

PURPOSE: To quantitatively evaluate the efficacy of interventions designed to prevent or treat obesity among U.S. minority children using meta-analytic techniques. METHODS: A total of 40 intervention trials involving 10,725 children aged 6-19 years were examined. RESULTS: Interventions with more components showed a higher mean effect size than those with fewer components: among 32 controlled trials, d = .07 for one-component (n = 6); d = .08 for two-component (n = 15); d = .33 for three-component (n = 10); and d = .71 for four-component (n = 1) interventions. Interventions with parental involvement (n = 22, d = .21) and lifestyle interventions (n = 14, d = .34) showed a greater mean effect size than those without parental involvement (n = 10, d = .05) or lifestyle interventions (n = 18, d = .04), despite the fact that their 90% confidence intervals overlapped. Among uncontrolled trials (n = 8), two-component interventions (n = 5) yielded d = .86 and three-component interventions (n = 3) yielded d = .96. CONCLUSIONS: Evidence indicates that, among U.S. minority children, obesity interventions with three or more components might be more efficacious than those using fewer components. Parental involvement, lifestyle change, culturally-based adaptation, and interactive computer programs seem to show promise in the reduction of obese minority children.

Comparison of risk factors for falls from height between commercial and residential roofers.

INTRODUCTION: The purpose of this investigation was to compare commercial roofers and residential roofers in terms of their behaviors, beliefs, working conditions, and attitudes toward the use of fall protection devices, which could lead to fall accidents. METHODS: A cross-sectional sample of 252 roofers participated in the survey in the Midwest (Wisconsin, Illinois, Michigan, Indiana, and Iowa). RESULTS: Residential roofers were more likely to fall (prevalence ratio = 2.28, 95% CI = 1.58, 3.29) [corrected] than commercial roofers. Race/ethnicity, company size, work type, existence [corrected] of fall protection programs, enforcement of fall protection device use, actual use of fall protection devices, years of experience as a roofer, and perceived level of safety at roofing sites were [corrected] significantly associated with fall accidents. IMPACT ON INDUSTRY: This study adds insight into fall accidents from roofs in the construction industry and provides industry-specific cautions against fall accidents that can be reflected in regulatory agency implementation.

A meta-analysis of psycho-behavioral obesity interventions among US multiethnic and minority adults.

OBJECTIVE: The present review examines efficacious psycho-behavioral interventions in preventing weight gains or reducing weight among US multiethnic and minority adults as few studies were conducted to review such interventions to date. METHODS: Data were examined from 24 controlled intervention studies, representing 23 programs and involving 13,326 adults. Studies were identified through manual and online search of databases that include MEDLINE, Academic Search Premier, ERIC, PsycARTICLES, SPORTDiscus, and CINAHL Plus. RESULTS: Whereas one-component (n=5, d=0.08, 90% CI=-0.04, 0.35) and two-component interventions (n=13, d=0.22, 90% CI=0.05, 0.40) showed a low mean effect size, three-component interventions (n=6, d=0.52, 90% CI=0.39, 0.65) showed a moderate effect size. Interventions conducted in individual sessions (n=15, d=0.40, 90% CI=0.24, 0.56) showed a higher mean effect size than group interventions (n=9, d=0.08, 90% CI=-0.04, 0.30) although the confidence intervals overlapped. CONCLUSIONS: The study results indicate that future obesity prevention interventions targeting multiethnic and minority adults might benefit from incorporating individual sessions, family involvement, and problem solving strategies into multi-component programs that focus on lifestyle changes.