Early exposure to added sugars via infant formula may explain high intakes of added sugars during complementary feeding beyond maternal modeling.

Background: Research has shown that early exposure to added sugars from table food is related to increased intake of added sugars in later childhood. The earliest window of exposure to added sugars may be in infancy via infant formula. However, beyond the well-established factors of maternal lifestyle and modeling, there is a lack of research examining how exposure to added sugars from infant formula influences infant/toddler added sugar intakes from table foods and sugar sweetened beverages (SSB). Objective: While accounting factors previously associated with infant/toddler added sugar intakes and maternal SSB consumption (proximal measure of maternal modeling), this study aims to examine if there is an association between added sugars in infant formula and added sugar intakes from table foods and SSB during the complementary feeding period. Methods: This is a secondary, cross-sectional analysis using three-day caregiver-reported 24-h dietary recalls in a cohort of infant/toddlers (n = 95), ages 9- < 16 mos., enrolled in a music intervention trial. Hierarchical stepwise regression was used to estimate the association between exposure to added sugars from infant formula and (1) intake of added sugars from table food and (2) SSB consumption. Infant/toddler SSB consumption was transformed to account for distributional properties. We performed incremental F-tests to determine whether the addition of each step improved model fit (R2). Results: Early exposure to added sugars via infant formula was associated with infant/toddler SSB (ΔR2 = 0.044, Finc (1, 87) =6.009, p = 0.016) beyond sociodemographic and maternal SSB consumption, but not with infant/toddler added sugar intakes from table foods (ΔR2 = 0.02, Finc (1, 87) =3.308, p = 0.072). Conclusion: While past studies have identified circumstantial (i.e., sociodemographic), or indirect (i.e., maternal lifestyle and modeling), mechanisms contributing to higher infant/toddler added sugar intakes, this study identifies exposure to added sugars from infant formula as a possible direct mechanism explaining why some infants/toddlers consume more added sugars.

Caregiver feeding decisions and sociodemographic characteristics are associated with snack food intake during infancy and toddlerhood.

Snacking starts early in childhood, yet little is known about child versus family influences on snacking during infancy and toddlerhood. This secondary analysis of baseline data examined associations of child characteristics (e.g., appetitive traits, temperament), caregiver feeding decisions, and sociodemographic characteristics with the mean frequency of (times/day) and mean energy from (kcal/day) child snack food intake. Caregivers and their children (ages 9-15 months) were recruited in Buffalo, NY from 2017 to 2019. Caregivers reported on sociodemographics, child appetitive traits (Baby Eating Behaviour Questionnaire), and child temperament (Infant Behavior Questionnaire-Revised). Three 24-h dietary recalls were collected, and USDA food categories were used to categorize snack foods (e.g., cookies, chips, and puffs). Hierarchical multiple linear regression models examined associations of child characteristics (Step 1: age, sex, baseline weight-for-length z-score, appetitive traits, and temperament), caregiver feeding decisions (Step 2: breastfeeding duration and age of solid food introduction), and caregiver sociodemographic characteristics (Step 3: caregiver age, prepregnancy BMI, education, and household size) with mean child snack food intake. Caregivers (n = 141) were on average 32.6 years of age, predominantly white (89.1%), and college-educated (84.2%). Age of solid food introduction (B = -0.21, p = 0.03), prepregnancy BMI (B = 0.03, p = 0.04), and household size (B = 0.23, p = 0.02) were significantly associated with the mean frequency of (times/day) snack food intake, over and above other variables of interest. Child age (B = 15.96, p = 0.002) was significantly associated with mean energy from (kcal/day) snack food intake. Household size (B = 28.51, p = 0.006) was significantly associated with mean energy from (kcal/day) snack food intake, over and above other variables of interest. There were no significant associations of other child characteristics with snack food intake. Findings show that child snack food intake is more closely associated with caregiver feeding decisions and sociodemographic characteristics than child characteristics. TRIAL REGISTRATION: National Institute on Child Health and Human Development, Grant/Award Number R01HD087082-01.

Reducing relative food reinforcement of infants using a music enrichment program: a randomized, controlled trial.

BACKGROUND: Food reinforcement or one's motivation to eat may be established early in life; it might not be the food reinforcement per se that drives weight gain, but rather the imbalance between food and nonfood reinforcement. OBJECTIVES: We implemented a 2-y randomized, controlled trial to assess the effects of a music enrichment program (music, n = 45) compared with an active play date control (control, n = 45) in 9- to 15-mo-old healthy infants who were strongly motivated to eat. METHODS: The 12-mo intensive intervention phase included 4 semesters of Music Together® or a play date program (Winter, Spring, Summer, and Fall), comprised of once per week group meetings, followed by a 12-mo maintenance phase with monthly meetings. Parents were encouraged to listen to the Music Together® program CD or play with the play date group's toy with their infants at home, respectively. We performed a modified intention-to-treat analysis using all randomly assigned, non-excluded subjects for the outcome measures [relative reinforcing value of food (RRVfood), food reinforcement, music reinforcement, and weight-for-length z-score (WLZ)]. RESULTS: There were significant differential group changes across time for RRVfood (group × month; P = 0.016; Cohen's f2 = 0.034). The music group had significantly greater RRVfood decreases than the control group from baseline to the end of the intensive intervention phase (music change = -0.211; control change = -0.015; P = 0.002; Cohen's D = 0.379). However, these differences were not maintained during months 12-24 (music change = -0.187; control change = -0.143; P = 0.448; D = 0.087). We observed an overall moderation effect by sex for food reinforcement and WLZ. Boys in the music group had a significant attenuation in food reinforcement and WLZ compared with boys in the control group. CONCLUSIONS: This study extends our knowledge in infant eating behavior by providing insight into the role of nonfood alternatives in altering one's motivation to eat. There may be sex differences in altering one's motivation to eat.This trial was registered at clinicaltrials.gov as NCT02936284.

The Association between Maternal Sugar-Sweetened Beverage Consumption and Infant/Toddler Added Sugar Intakes.

Intake of added sugars during early life is associated with poor health outcomes. Maternal dietary intake influences the intake of their children, but little research investigates the relationship between maternal sugar sweetened beverage (SSB) and infant/toddler added sugar intakes. Our objective was to explore the relationship between maternal total sugars and SSB intakes and infant/toddler added sugar intakes. This cross-sectional study (n = 101) of mother-infant dyads measured maternal dietary intake by food frequency questionnaire and infant intake by three 24-h dietary recalls. Pearson's correlations explored the relations between maternal total sugars and SSB intakes and infant added sugar intakes. Hierarchical stepwise regressions determined if maternal total sugars and SSB intakes explained the variation in infant added sugar intakes after accounting for known risk factors for early introduction of added sugars. Maternal total sugars (r = 0.202, p = 0.043) and SSB (r = 0.352, p < 0.001) intakes were positively correlated with infant/toddler added sugar intakes. In the hierarchical models, maternal total sugar intakes did not account for more variance in infant added sugar intakes (ß = 0.046, p = 0.060), but maternal SSB intake was a significant contributor of infant added sugar intakes (ß = 0.010, p = 0.006) after accounting for confounders. Interventions to reduced maternal SSB consumption may help reduce infant/toddler added sugar intakes.

Frequency of Sweet and Salty Snack Food Consumption Is Associated with Higher Intakes of Overconsumed Nutrients and Weight-For-Length z Scores During Infancy and Toddlerhood.

BACKGROUND: Current dietary guidelines recommend avoiding foods and beverages with added sugars and higher sodium before age 2 years. OBJECTIVE: The aim was to describe daily snack food intake (frequency and total energy) and the associations with overconsumed nutrients (added sugars, sodium, and saturated fats) and child weight-for-length z scores. DESIGN: A cross-sectional, secondary analysis of baseline data from an ongoing longitudinal intervention was conducted. PARTICIPANTS AND SETTING: A sample of 141 caregivers with infants (aged 9 to 11 months) and toddlers (aged 12 to 15 months) was recruited in Buffalo, NY, between 2017 and 2019. MAIN OUTCOME MEASURES: Three 24-hour dietary recalls were used to categorize 'sweet and salty snack foods' or 'commercial baby snack foods' based on the US Department of Agriculture What We Eat in America food group classifications and estimate nutrient intakes. Child recumbent length and weight were measured by trained researchers. STATISTICAL ANALYSIS: Daily frequency (times/day), energy (kcal/day), and overconsumed nutrients from snack food intake were calculated. Multivariable regression models examined associations between the frequency of and energy from snack food intake with overconsumed nutrients and child weight-for-length z scores. RESULTS: Infants consumed snack foods on average 1.2 times/day contributing 5.6% of total daily energy, 19.6% of added sugars, and 6.8% of sodium. Toddlers consumed snack foods on average 1.4 times/day contributing 8.9% of total daily energy, 40.0% of added sugars, and 7.2% of sodium. In adjusted models including all children, greater frequency of sweet and salty snack food intake, but not commercial baby snack foods, was associated with higher weight-for-length z scores. CONCLUSIONS: Snack foods are frequently consumed by infants and toddlers and contribute to the intake of overconsumed nutrients such as added sugars and sodium. Given the current guidelines to avoid added sugars and higher sodium before age 2 years, additional recommendations related to nutrient-dense snack intake may be beneficial.

Added sugars mediate the relation between pre-pregnancy BMI and infant rapid weight gain: a preliminary study.

BACKGROUND: Parental obesity is linked to offspring obesity, though little research has explored factors that might influence this relationship during the complementary feeding period. This study investigated whether infant intakes of added sugars mediate the relationship between a mother's pre-pregnancy body mass index (BMI) and infant rapid weight gain (defined as upward weight-for-age percentile crossing). METHODS: This study was of a cross-sectional design. Anthropometrics for 141 mother-infant dyads (mean age [standard deviation]: 32.6 [4.4] year for mothers, 11.9 [1.9] months for infants) were obtained. Data from three 24-h recalls pertaining to the infants' diets were collected and analyzed. Pearson product-moment correlations and multivariable regressions assessed bivariate relationships between pre-pregnancy BMI, infant added sugar intakes and upward weight-for-age percentile crossing. Mediation models evaluated the effects of added sugars and breastfeeding duration. RESULTS: Pre-pregnancy BMI correlated positively with infants' added sugar intakes (r = 0.230, p = 0.006). Added sugar intakes mediated the impact of pre-pregnancy BMI on upward weight-for-age percentile crossing (indirect effect = 0.007, 95% CI = 0.0001, 0.0197, indirect/total effect ratio = 0.280). Breastfeeding duration also moderated the relationship, with infants who were breastfed for a shorter duration experiencing a greater mediating effect (indirect effect = 0.010, 95% CI = 0.0014, 0.0277, indirect/direct effect ratio = 0.7368). CONCLUSIONS: Mothers who were overweight or obese prior to pregnancy were significantly more likely to give their infants foods and beverages with added sugars, and this practice was found to mediate the relationship between maternal and infant obesity. Breastfeeding duration moderated the mediating effect of added sugars between pre-pregnancy BMI and infant rapid weight gain.

The Prevalence of Hyperpalatable Baby Foods and Exposure During Infancy: A Preliminary Investigation.

Objective: To characterize the prevalence of hyperpalatable foods (HPF) among baby foods in the U.S. and examine the prevalence of HPF exposure and consumption from both baby food and adult food sources among infants aged 9-15 months. Methods: A U.S. baby food database as well as baby foods from three 24-h dietary recalls of 147 infants were used to identify baby foods as HPF per previous publication. HPF exposure was defined as intake of any HPF during the 3-day measurement period. To determine the extent of HFP consumption, % kilocalorie (kcal) intake from HPF was characterized. Results: Only 12% of baby foods were HPF; however, nearly all participants (>90%) consumed HPF, primarily through exposure to adult foods. Younger infants (<12 months) consumed 38% [standard deviation (SD) = 23.6%] of their daily food kcal from HPF and older infants (≥12 months) consumed 52% (SD = 16.4%) of daily food kilocalorie from HPF. Most younger infants (68%) and older infants (88%) had repeated exposure to the same HPF across the measurement period. Conclusions: The prevalence of HPF among baby foods in the U.S. is low. However, almost all infants were exposed to HPF, and HPF comprised a substantial percentage of daily food kilocalorie in infants' diets. Findings highlight the transition to solid food consumption during complimentary feeding period is a critical time for early HPF exposure.

Association Between Added Sugars from Infant Formulas and Rapid Weight Gain in US Infants and Toddlers.

BACKGROUND: Formulas often contain high amounts of added sugars, though little research has studied their connection to obesity. OBJECTIVES: This study assessed the contribution of added sugars from formulas during complementary feeding on total added sugar intakes, and the association between these sugars and upward weight-for-age percentile (WFA%) crossing (i.e., participants crossing a higher threshold percentile were considered to have an upward crossing). METHODS: Data from three 24-hour dietary recalls for infants (n = 97; 9-12 months) and toddlers (n = 44; 13-15 months) were obtained in this cross-sectional analysis. Foods and beverages with added sugars were divided into 17 categories. Pearson's correlations were used to test relations between added sugar intake and upward WFA% crossing, followed by multivariable regressions when significant. ANOVA compared intakes of all, milk-based, and table foods between primarily formula-fed compared with breastfed participants. Multivariable regressions were used to test effects of added sugars and protein from all foods compared with added sugars and protein from milk-based sources on upward WFA% crossing. RESULTS: Added sugars from formulas comprised 66% and 7% of added sugars consumed daily by infants and toddlers, respectively. A significant association was observed between upward WFA% crossing and added sugars from milk-based sources after controlling for gestational age, sex, age, introduction to solid foods, mean energy intakes, and maternal pre-pregnancy BMI and education (ß = 0.003; 95% CI, 0.000-0.007; P = 0.046). Primarily formula-fed participants consumed nearly twice the energy from added sugars (P = 0.003) and gained weight faster (upward WFA% crossing = 1.1 ± 1.2 compared with 0.3 ± 0.6, respectively; P < 0.001) than their breastfed counterparts. CONCLUSIONS: Added sugars in formulas predict rapid weight gain in infants and toddlers. Educating mothers on lower-sugar options may enhance childhood obesity prevention.

High intake of added sugars is linked to rapid weight gain in infancy, breastfeeding ≥12 months may protect against this: A preliminary investigation.

BACKGROUND: Consumption of added sugars is linked to excess adiposity in older age groups and breastfeeding has been shown to protect against later obesity. OBJECTIVES: This investigation aimed to determine whether intake of added sugars associates with rapid weight gain in individuals under 2 years of age, if intake of added sugars associates with breastfeeding duration, and how both influence body weight. METHODS: A cross-sectional analysis of data from three 24-hours dietary recalls collected from 141 infants/toddlers (age 11.9 ± 1.9 months, 44.7% male) was performed. Multivariable regressions assessed relationships between added sugar intakes, breastfeeding duration, and weight status. Hierarchical regressions examined added variance accounted for in rapid weight gain (specifically, upward weight-for-age percentile [WFA %tile] crossing) through the interaction of added sugars * breastfeeding duration. RESULTS: Added sugars correlated positively with upward WFA %tile crossing (r = 0.280, P < .001) and negatively with breastfeeding duration (r = -0.468, P < .001). Consumption of added sugars was a significant predictor of rapid weight gain when breastfeeding duration was short (<12 months, ß = 0.020, P = .029), but not long (≥12 months, ß = 0.001, P = .875). CONCLUSIONS: A high intake of added sugars in individuals below age 2 associates with rapid weight gain, though breastfeeding ≥12 months appears protective against this. Further studies are necessary to substantiate these findings and provide insight into underlying mechanisms.

Functional connectivity: a source of variance in the association between cardiorespiratory fitness and cognition?

Over the next 20 years the number of Americans diagnosed with dementia is expected to more than double (CDC, 2007). It is, therefore, an important public health initiative to understand what factors contribute to the longevity of a healthy mind. Both default mode network (DMN) function and increased aerobic fitness have been associated with better cognitive performance and reduced incidence of Alzheimer's disease among older adults. Here we examine the association between aerobic fitness, functional connectivity in the DMN, and cognitive performance. Results showed significant age-related deficits in functional connectivity in both local and distributed DMN pathways. However, in a group of healthy elderly adults, almost half of the age-related disconnections showed increased functional connectivity as a function of aerobic fitness level. Finally, we examine the hypothesis that functional connectivity in the DMN is one source of variance in the relationship between aerobic fitness and cognition. Results demonstrate instances of both specific and global DMN connectivity mediating the relationship between fitness and cognition. We provide the first evidence for functional connectivity as a source of variance in the association between aerobic fitness and cognition, and discuss results in the context of neurobiological theories of cognitive aging and disease.

Preliminary evidence that self-efficacy predicts physical activity in multiple sclerosis.

Individuals with multiple sclerosis (MS) are less physically active than non diseased people. One method for increasing physical activity levels involves the identification of factors that correlate with physical activity and that are modifiable by a well designed intervention. This study examined two types of self-efficacy as cross-sectional and prospective correlates of objectively measured physical activity in 16 individuals with a diagnosis of MS. The participants completed two measures of self-efficacy and then wore an accelerometer for a 5-day period at baseline and then at 3 months follow-up. Self-efficacy for continued physical activity was associated with baseline and follow-up levels of physical activity. Self-efficacy for overcoming barriers was associated with follow-up levels of physical activity and change in physical activity across a 3-month period. Researchers should consider self-efficacy as a possible component of an intervention that is designed to increase physical activity levels in those with MS. International Journal of Rehabilitation Research

Aerobic fitness is associated with hippocampal volume in elderly humans.

Deterioration of the hippocampus occurs in elderly individuals with and without dementia, yet individual variation exists in the degree and rate of hippocampal decay. Determining the factors that influence individual variation in the magnitude and rate of hippocampal decay may help promote lifestyle changes that prevent such deterioration from taking place. Aerobic fitness and exercise are effective at preventing cortical decay and cognitive impairment in older adults and epidemiological studies suggest that physical activity can reduce the risk for developing dementia. However, the relationship between aerobic fitness and hippocampal volume in elderly humans is unknown. In this study, we investigated whether individuals with higher levels of aerobic fitness displayed greater volume of the hippocampus and better spatial memory performance than individuals with lower fitness levels. Furthermore, in exploratory analyses, we assessed whether hippocampal volume mediated the relationship between fitness and spatial memory. Using a region-of-interest analysis on magnetic resonance images in 165 nondemented older adults, we found a triple association such that higher fitness levels were associated with larger left and right hippocampi after controlling for age, sex, and years of education, and larger hippocampi and higher fitness levels were correlated with better spatial memory performance. Furthermore, we demonstrated that hippocampal volume partially mediated the relationship between higher fitness levels and enhanced spatial memory. Our results clearly indicate that higher levels of aerobic fitness are associated with increased hippocampal volume in older humans, which translates to better memory function.

Dedifferentiation in the visual cortex: an fMRI investigation of individual differences in older adults.

Dedifferentiation, or decreased processing specificity, has been suggested to represent a ubiquitous characteristic of cognitive aging. In this study, we examined both age-related differences and intra-group differences in neural specificity in the ventral visual cortex for color, words, faces and places. Our results demonstrated that neural dedifferentiation was not ubiquitous across stimulus categories. Neural dedifferentiation was also relatively stable, across age, in a group of older adults. Older adults with more overall gray matter showed less neural dedifferentiation in the visual cortex. However, regional gray matter volume was not associated with neural dedifferentiation. We illustrate these effects using a discriminability metric, a signal detection theory measure, for neural dedifferentiation that takes into account both magnitude and variance of brain activation. The dedifferentiation measure provides a quantitative means to examine activation patterns and individual difference factors associated with neural dedifferentiation, and to test theories of behavioral dedifferentiation in cognitive aging literature.

Pathways from physical activity to quality of life in older women.

BACKGROUND: In spite of consistent evidence to suggest that being more physically active is associated with enhanced quality of life (QOL), there have been remarkably few attempts to determine the possible underlying mechanisms in this relationship. PURPOSE: To prospectively examine the roles played by self-efficacy and physical and mental health status in the physical activity and QOL relationship in older women. METHOD: Older women (M age = 68.12 years) completed measures of physical activity, self-efficacy relative to balance, mental and physical health status, and global QOL at baseline (N = 249) and 24-month follow-up (N = 217). Demographics and general health information were assessed at baseline. A panel analysis within a covariance modeling framework was used to analyze the data. RESULTS: Analyses indicated that changes in physical activity over time were associated with residual changes in self-efficacy. Changes in self-efficacy were significantly associated with residual changes in physical and mental health status. Only changes in mental health status were significantly related to residual changes in global QOL. CONCLUSION: Results from this study support the role of self-efficacy in the relationship between physical activity and QOL. Future physical activity promotion programs should include strategies to enhance self-efficacy for physical activity to be most effective for this population.

Neighborhood satisfaction, functional limitations, and self-efficacy influences on physical activity in older women.

BACKGROUND: Perceptions of one's environment and functional status have been linked to physical activity in older adults. However, little is known about these associations over time, and even less about the possible mediators of this relationship. We examined the roles played by neighborhood satisfaction, functional limitations, self-efficacy, and physical activity in a sample of older women over a 6-month period. METHODS: Participants (N = 137, M age = 69.6 years) completed measures of neighborhood satisfaction, functional limitations, self-efficacy, and physical activity at baseline and again 6 months later. RESULTS: Analyses indicated that changes in neighborhood satisfaction and functional limitations had direct effects on residual changes in self-efficacy, and changes in self-efficacy were associated with changes in physical activity at 6 months. CONCLUSION: Our findings support a social cognitive model of physical activity in which neighborhood satisfaction and functional status effects on physical activity are in part mediated by intermediate individual outcomes such as self-efficacy. Additionally, these findings lend support to the position that individual perceptions of both the environment and functional status can have prospective effects on self-efficacy cognitions and ultimately, physical activity behavior.

Self-efficacy and environmental correlates of physical activity among older women and women with multiple sclerosis.

Physical inactivity is a major health problem in the United States, particularly in elderly and disabled populations. Little research exists examining the relationships between aspects of the built environment and physical activity in older adults and individuals with multiple sclerosis (MS). We adopted a social cognitive perspective to examine the independent roles of perceptions of the environmental, self-efficacy and functional limitations in understanding physical activity levels among elderly women and women with MS. Older women (n=136) and women diagnosed with MS (n=173) were recruited to participate in separate cross-sectional studies. Individuals completed a battery of questionnaires and wore an activity monitor for 7 days. All measures were issued and collected through the mail with the use of self-addressed, pre-paid envelopes. Initial correlational analyses indicated that self-efficacy, functional limitations and environmental perceptions were significantly related to physical activity. Among older women, self-efficacy, functional limitations and street connectivity demonstrated independent contributions to physical activity behavior. Only self-efficacy and functional limitations demonstrated significant associations among women with MS. The prospective contributions of the environment and individual factors to changes in physical activity need to be determined.

Self-efficacy effects on neuroelectric and behavioral indices of action monitoring in older adults.

The relationships between self-efficacy (SE), i.e., beliefs in personal capabilities, and behavioral and neuroelectric (i.e., ERN, Pe) indices of action monitoring were investigated in 40 older adults (13 male) during the completion of a flanker paradigm performed under task conditions emphasizing either accuracy or speed. SE relative to task performance during both conditions was assessed prior to each cognitive task. Results indicated that high-SE older adults exhibited larger ERN and Pe amplitudes compared to low-SE older adults under the accuracy instruction condition. Additionally, a moderating effect of SE on the relationship between ERN and post-error response accuracy was revealed in the accuracy condition, with greater ERN amplitude associated with greater post-error accuracy in the high-SE group. No significant relationships were evident between ERN and post-error accuracy in the low-SE group. Further, no significant relationships involving SE were observed in the speed condition. The findings suggest that SE may be related to neuroelectric and behavioral indices of action monitoring in older adults when task demands require greater attention to action monitoring processes.

Effects of change in physical activity on physical function limitations in older women: mediating roles of physical function performance and self-efficacy.

OBJECTIVES: To examine the hypothesis that changes in self-efficacy and functional performance mediate, in part, the beneficial effect of physical activity on functional limitations over time. DESIGN: Prospective, observational study. SETTING: Community-based. PARTICIPANTS: Two hundred forty-nine community-dwelling older women. MEASUREMENTS: Participants completed measures of self-reported physical activity, functional limitations, and self-efficacy. Four measures of physical function performance were also assessed. Measures were completed at baseline and 24 months. Data were analyzed using a panel model within a covariance modeling framework. RESULTS: Results indicated that increases in physical activity over time were associated with greater improvements in self-efficacy, which was associated in turn with improved physical function performance, both of which mediated the association between physical activity and functional limitations. Fewer functional limitations at baseline were also associated with higher levels of self-efficacy at 24 months. Age, race, and health status covariates did not significantly change these relationships. CONCLUSION: The findings support the mediating roles of self-efficacy and physical function performance in the relationship between longitudinal changes in physical activity and functional limitations in older women.

Long-term follow-up of physical activity behavior in older adults.

OBJECTIVE: To examine the contribution of social-cognitive factors (self-efficacy and affect) in predicting long-term physical activity in a sample of older adults (N=174). DESIGN: A prospective design assessed physical activity and psychosocial variables at 2 and 5 years following a 6-month randomized, controlled exercise trial. MAIN OUTCOME MEASURES: The primary outcome variable was self-reported physical activity, with previous behavior, self-efficacy, and affect assessed as determinants of physical activity. RESULTS: Covariance modeling analyses indicated that physical activity at Year 2 was the strongest predictor of physical activity at 5-year follow-up. Both self-efficacy and affect at Year 2 were also associated with physical activity at Year 5, as was original treatment condition. Variables accounted for 35% of the variance in Year 5 activity. CONCLUSION: Older adults with higher levels of physical activity, more positive affect, and higher self-efficacy at Year 2 were more likely to continue to be active at Year 5. This study is one of the longest follow-ups of exercise behavior in older adults and has implications for structuring environments to maximize the maintenance of physical activity.

Physical activity and functional limitations in older women: influence of self-efficacy.

This study examined the role of self-efficacy and physical function performance in the relationship between physical activity and functional limitations. Older women (age, M = 68.2 years) completed measures of physical activity, self-efficacy, physical function performance, and functional limitations at the baseline of an ongoing study. Analyses indicated that physical activity was associated with self-efficacy for exercise, efficacy for gait and balance, and physical function performance. Both measures of efficacy and physical functional performance were associated with functional limitations. Demographic and health status variables did not differentially influence these relationships. Although cross-sectional in nature, our findings suggest that physical activity, self-efficacy, and functional performance may all play a role in reducing functional limitations. Of particular relevance is the fact that both physical activity and self-efficacy represent important, modifiable factors that can enhance function.