The Eating Attitudes Test (EAT-26) is probably the most widely used and cited standardized measure of symptoms and concerns characteristic of eating disorders . The original EAT appeared as a Current Contents Citation Classic in 1993. The 26-item version is highly reliable and valid according to Wikipedia. Many studies have used the EAT-26 as an economical first step in a two-stage screening process.
Thinking About Success and Failure in Obesity CareObesityHelp
Even though obesity has officially been classified as disease by important groups like the American Medical Association, many people – doctors included – put all the emphasis on the scale and on other measures like body mass index (BMI). In this talk we will look at how success is measured now and other ways to define success after bariatric surgery. Time allowing, we will also talk about some of the long-term issues related to health and nutrition after bariatric surgery, with a focus on things that contribute to weight regain.
Nutritional Rehabilitation for Eating DisordersDavid Garner
This report describes our approach in sufficient detail to allow our outcomes to be replicated and compared with other programs. Our approach to meal planning has been referred to as “mechanical eating” and consists of a structured eating program in which quantity of food consumed, type of food consumed and spacing of meals, are all specified in advance. This report describes our approach in sufficient detail to allow our outcomes to be replicated and compared with other programs. We have anticipated potential criticisms of this
approach and have provided the theoretical and practical basis for our model.
The Eating Attitudes Test (EAT-26) is probably the most widely used and cited standardized measure of symptoms and concerns characteristic of eating disorders . The original EAT appeared as a Current Contents Citation Classic in 1993. The 26-item version is highly reliable and valid according to Wikipedia. Many studies have used the EAT-26 as an economical first step in a two-stage screening process.
Thinking About Success and Failure in Obesity CareObesityHelp
Even though obesity has officially been classified as disease by important groups like the American Medical Association, many people – doctors included – put all the emphasis on the scale and on other measures like body mass index (BMI). In this talk we will look at how success is measured now and other ways to define success after bariatric surgery. Time allowing, we will also talk about some of the long-term issues related to health and nutrition after bariatric surgery, with a focus on things that contribute to weight regain.
Nutritional Rehabilitation for Eating DisordersDavid Garner
This report describes our approach in sufficient detail to allow our outcomes to be replicated and compared with other programs. Our approach to meal planning has been referred to as “mechanical eating” and consists of a structured eating program in which quantity of food consumed, type of food consumed and spacing of meals, are all specified in advance. This report describes our approach in sufficient detail to allow our outcomes to be replicated and compared with other programs. We have anticipated potential criticisms of this
approach and have provided the theoretical and practical basis for our model.
Ms Susan Moug's keynote speech 'The Promotion of Physical Activity - Everyone's Responsibility' at the SCPN's 'Be Active Against Cancer' conference, Tuesday 4th February 2014.
Sex differences in the links between disordered eating and admiration for peo...Scoti Riff
Background: Disordered eating in young women is positively associated with their admiration for women with anorexia nervosa. However, little is known about sex differences in this association, or whether the association extends to muscle dysmorphia.
Aims: The present study aimed to investigate sex differences in the associations between young peoples’ disordered eating and their admiration for people with anorexia nervosa and muscle dysmorphia.
Method: Male (n = 174) and female (n = 325) undergraduates read one of four descriptions of a male or female character with anorexia nervosa or muscle dysmorphia. Participants then answered questions about their admiration for the characters and completed a measure of disordered eating.
Results: Averaged across character diagnosis and character sex, female participants expressed greater desire to be like the characters than males. For females, moderate to large positive correlations were observed between disordered eating and admiration for characters with both anorexia nervosa and muscle dysmorphia. For males, moderate positive correlations emerged between disordered eating and admiration for muscle dysmorphia, and a single small positive correlation was observed for anorexia nervosa.
Conclusions: The results indicate important sex differences in the associations between young peoples’ disordered eating and their admiration for anorexia nervosa and muscle dysmorphia.
“Pathological Motivations for Exercise and Eating Disorder Specific Health-Re...pmilano
Exercise, as we all know, can improve your health, but if you have an eating disorder and also exercise compulsively to help manage your weight, you may find your overall quality of life going down even further.
Those are some of the findings of research by JU Professor of Kinesiology Heather Hausenblas and colleagues in a study titled “Pathological Motivations for Exercise and Eating Disorder Specific Health-Related Quality of Life” published in the April 2014 issue of the International Journal of Eating Disorders.
Effect of Maternal Physical Activity on Pregnancy and Birthing OutcomesKimberly Rooker
A meta-analysis of assessed maternal and fetal responses to exercise in regards to pregnancy and birthing outcomes; possible risks and benefits of exercise during pregnancy; and current recommendations for exercise during pregnancy.
Ms Susan Moug's keynote speech 'The Promotion of Physical Activity - Everyone's Responsibility' at the SCPN's 'Be Active Against Cancer' conference, Tuesday 4th February 2014.
Sex differences in the links between disordered eating and admiration for peo...Scoti Riff
Background: Disordered eating in young women is positively associated with their admiration for women with anorexia nervosa. However, little is known about sex differences in this association, or whether the association extends to muscle dysmorphia.
Aims: The present study aimed to investigate sex differences in the associations between young peoples’ disordered eating and their admiration for people with anorexia nervosa and muscle dysmorphia.
Method: Male (n = 174) and female (n = 325) undergraduates read one of four descriptions of a male or female character with anorexia nervosa or muscle dysmorphia. Participants then answered questions about their admiration for the characters and completed a measure of disordered eating.
Results: Averaged across character diagnosis and character sex, female participants expressed greater desire to be like the characters than males. For females, moderate to large positive correlations were observed between disordered eating and admiration for characters with both anorexia nervosa and muscle dysmorphia. For males, moderate positive correlations emerged between disordered eating and admiration for muscle dysmorphia, and a single small positive correlation was observed for anorexia nervosa.
Conclusions: The results indicate important sex differences in the associations between young peoples’ disordered eating and their admiration for anorexia nervosa and muscle dysmorphia.
“Pathological Motivations for Exercise and Eating Disorder Specific Health-Re...pmilano
Exercise, as we all know, can improve your health, but if you have an eating disorder and also exercise compulsively to help manage your weight, you may find your overall quality of life going down even further.
Those are some of the findings of research by JU Professor of Kinesiology Heather Hausenblas and colleagues in a study titled “Pathological Motivations for Exercise and Eating Disorder Specific Health-Related Quality of Life” published in the April 2014 issue of the International Journal of Eating Disorders.
Effect of Maternal Physical Activity on Pregnancy and Birthing OutcomesKimberly Rooker
A meta-analysis of assessed maternal and fetal responses to exercise in regards to pregnancy and birthing outcomes; possible risks and benefits of exercise during pregnancy; and current recommendations for exercise during pregnancy.
Eating Disorders and Self Esteem in Adolescents, Teens, and .docxjacksnathalie
Eating Disorders and Self Esteem in Adolescents, Teens, and Young Adults
A Comparative Analysis
Johnson, F., & Wardle, J. (2005). Dietary restraint, body dissatisfaction, and psychological distress: A prospective analysis. Journal of Abnormal Psychology, 114(1), 119-125. doi:10.1037/0021-843X.114.1.119
Olivardia, R., Pope, H. r., Borowiecki, J., & Cohane, G. H. (2004). Biceps and body image: The relationship between muscularity and self-esteem, depression, and eating disorder symptoms. Psychology of Men &Masculinity, 5(2), 112-120. doi:10.1037/1524-9220.5.2.112
Eating Disorders and Self Esteem in Adolescents, Teens, and Young Adults
How do self-esteem and eating disorders interact with one another in terms of gender bias, gender difference, and gender predisposition?
Is there a correlation between self-esteem and eating disorders and if so, can a symbiotic or cyclical relationship be determined?
Introduction
Body image, eating disorders, self-esteem, and muscularity are all very significant and pressing issues facing adolescents and young adults. The reasons for the formations of maladaptive behaviors associated with these issues warrant review some of the research literature surrounding them. Hopefully the following will bring to light pertinent and helpful information on the subject in regard to similarities and/or differences between genders as well as what role society/environment and internal perceptions have in influencing the formation of eating disorders in this vulnerable and at risk population.
Johnson, F., & Wardle, J. (2005).
Research Article 1:
Dietary Restraint, Body Dissatisfaction, and Psychological Distress: A Prospective Analysis
What are the Authors Research Questions?
Examination of the cross-sectional and longitudinal relationship between dietary restraint and:
Investigation of the relationships between body dissatisfaction and:
Examination of the effects of dietary restraint and body dissatisfaction simultaneously in the same analytic model to compare their predictive power for:
Binge Eating, Emotional Eating, Abnormal Eating Attitudes Toward Eating And Weight
Depression, Stress, Low Self-esteem
Prospective Cohort Design
This is a design which is both cross-sectional and longitudinal
The Design
Operational Definitions For This Research Study
Cohorts-Group of similar individuals who share certain characteristics
Longitudinal-Following over a period of time to observe variation or change
Cross-sectional-refers to collecting data from cohorts at one particular point in time
Dietary Restraint-intentional efforts to achieve or maintain a desired weight
through reduced caloric intake
Body Dissatisfaction-Extent to which concerns about body shape cause distress and interfere with normal activities.
Stratified Random Sampling Method
1,177 Adolescent Females between the Ages of 13-15 Years
Attending 6 Secondary Schools in North West England
98% of girls present participated representing 84% of the to ...
Body mass-index-quality-of-life-and-migraine-in-studentsAnnex Publishers
Migraine is reported globally with a higher prevalence in students. The present study aims to evaluate the association between nutritional status, quality of life (QL) and characteristics of migraine.
A cross-sectional study. Headache characteristics, level of disability caused by migraine crises (Pediatric Migraine Disability Assessment - PedMIDAS) and QL (Pediatric Quality of Life Inventory- PedsQL) were assessed. Anthropometric variables were also measured.
Data were collected from 98 students with a mean age of 11.2 ± 1.7 years. Migraine had the highest prevalence (54.8%). The average Body Mass Index (BMI) of the total sample was 20.0 ± 3.8 kg/m2, and among students with migraine and students with tension headache, the average BMIs were 20.4 ± 4.0 and 19.5 ± 3.4 kg/m2, respectively (p = 0.264, Student's t-test). Around 47.5% from migraineurs were overweight or obese. Regarding QL, the average total score in students with migraine was 74.4 ± 12.4, with no differences observed among normal weight, overweight or obese students, and no correlation between the scores of the PedsQL and BMI (r = -0.182, p = 0.165, Pearson correlation coefficient) was observed. There was a high percentage of overweight students with migraine. Analyses show no associations between the nutritional status, frequency, severity, disability caused by crises, or QL.
Relationship of body mass index, fat and visceral fat among adolescentsSports Journal
In the present study the researcher studied out the correlation of Body mass index, Fat and visceral fat
among adolescents. Data was statically analyzed using descriptive statistics and Pearson Product Multi
Correlation Coefficient was used (PPMCC). It was find out that body mass index was significantly
correlated with fat and visceral fat and on the other hand fat was also significantly correlated with
visceral fat among adolescents.
A poster I lead and presented at the 2017 annual meeting of the American Congress of Rehabilitation Medicine. It won the Early Career poster award from the Brain Injury Interdisciplinary Special Interest Group
Company Chosen Suncorp Bank Across Australia and globally, th.docxjanthony65
Company Chosen: Suncorp Bank
Across Australia and globally, the nature and practice of Human Resource Management (HRM) is in a constant state of evolution as organisational forms, management standards, labour markets and whole economies shift, adapt and change. In this assignment you are required to select an organisation, and undertake an investigation and evaluation regarding the HRM practices and policies present in that organisation. Your assignment is thus in two parts. The first section (of approximately 900 words) requires you to account for, and discuss, the ways in which your selected organisation:
· Recruits and inducts new staff
· Manages staff performance and engagement
· Identifies and advances high performing staff
· Ensures that staff operate safely
· Advances a diversity agenda across its staff and management base
· Encourages staff to stay at the organisation
· Resolves disputes and/or negotiates pay and benefits
In the second part of the assignment (approximately 1100 words in length) you should offer informed suggestions, supported by peer-reviewed academic literature (i.e. quality journal articles) on how the organisation can better structure its HRM practices and policies to advance employee performance (such as engagement, wellbeing, safety, commitment etc.) and organisational outcomes (e.g. profit and standing). Your suggestions should be critical and based on evidence, and at least 8 peer-reviewed academic articles should be cited in this section.
Home-based exergaming among children with
overweight and obesity: a randomized clinical trial
A. E. Staiano , R. A. Beyl , W. Guan , C. A. Hendrick , D. S. Hsia and
R. L. Newton Jr.
Pennington Biomedical Research Center, Baton
Rouge, Louisiana, USA
Address for correspondence:
AE Staiano, Pennington Biomedical
Research Center, 6400 Perkins Rd,
Baton Rouge, LA 70815, USA.
E-mail: [email protected]
Received 14 February 2018; revised 30 April 2018;
accepted 26 May 2018
Summary
Background: Given children’s low levels of physical activity and high
prevalence of obesity, there is an urgent need to identify innovative physical activity
options.
Objective: This study aims to test the effectiveness of exergaming (video
gaming that involves physical activity) to reduce children’s adiposity and improve
cardiometabolic health.
Methods: This randomized controlled trial assigned 46 children with
overweight/obesity to a 24-week exergaming or control condition. Intervention par-
ticipants were provided a gaming console with exergames, a gameplay curriculum
(1 h per session, three times a week) and video chat sessions with a fitness coach
(telehealth coaching). Control participants were provided the exergames following fi-
nal clinic visit. The primary outcome was body mass index (BMI) z-score. Secondary
outcomes were fat mass by dual energy X-ray absorptiometry and cardiometabolic
health metrics.
Results: Half of the participants were girls, and 57% were African–American.
Int.
Company Chosen Suncorp Bank Across Australia and globally, th.docxtemplestewart19
Company Chosen: Suncorp Bank
Across Australia and globally, the nature and practice of Human Resource Management (HRM) is in a constant state of evolution as organisational forms, management standards, labour markets and whole economies shift, adapt and change. In this assignment you are required to select an organisation, and undertake an investigation and evaluation regarding the HRM practices and policies present in that organisation. Your assignment is thus in two parts. The first section (of approximately 900 words) requires you to account for, and discuss, the ways in which your selected organisation:
· Recruits and inducts new staff
· Manages staff performance and engagement
· Identifies and advances high performing staff
· Ensures that staff operate safely
· Advances a diversity agenda across its staff and management base
· Encourages staff to stay at the organisation
· Resolves disputes and/or negotiates pay and benefits
In the second part of the assignment (approximately 1100 words in length) you should offer informed suggestions, supported by peer-reviewed academic literature (i.e. quality journal articles) on how the organisation can better structure its HRM practices and policies to advance employee performance (such as engagement, wellbeing, safety, commitment etc.) and organisational outcomes (e.g. profit and standing). Your suggestions should be critical and based on evidence, and at least 8 peer-reviewed academic articles should be cited in this section.
Home-based exergaming among children with
overweight and obesity: a randomized clinical trial
A. E. Staiano , R. A. Beyl , W. Guan , C. A. Hendrick , D. S. Hsia and
R. L. Newton Jr.
Pennington Biomedical Research Center, Baton
Rouge, Louisiana, USA
Address for correspondence:
AE Staiano, Pennington Biomedical
Research Center, 6400 Perkins Rd,
Baton Rouge, LA 70815, USA.
E-mail: [email protected]
Received 14 February 2018; revised 30 April 2018;
accepted 26 May 2018
Summary
Background: Given children’s low levels of physical activity and high
prevalence of obesity, there is an urgent need to identify innovative physical activity
options.
Objective: This study aims to test the effectiveness of exergaming (video
gaming that involves physical activity) to reduce children’s adiposity and improve
cardiometabolic health.
Methods: This randomized controlled trial assigned 46 children with
overweight/obesity to a 24-week exergaming or control condition. Intervention par-
ticipants were provided a gaming console with exergames, a gameplay curriculum
(1 h per session, three times a week) and video chat sessions with a fitness coach
(telehealth coaching). Control participants were provided the exergames following fi-
nal clinic visit. The primary outcome was body mass index (BMI) z-score. Secondary
outcomes were fat mass by dual energy X-ray absorptiometry and cardiometabolic
health metrics.
Results: Half of the participants were girls, and 57% were African–American.
Int.
Company Chosen Suncorp Bank Across Australia and globally, th.docxmccormicknadine86
Company Chosen: Suncorp Bank
Across Australia and globally, the nature and practice of Human Resource Management (HRM) is in a constant state of evolution as organisational forms, management standards, labour markets and whole economies shift, adapt and change. In this assignment you are required to select an organisation, and undertake an investigation and evaluation regarding the HRM practices and policies present in that organisation. Your assignment is thus in two parts. The first section (of approximately 900 words) requires you to account for, and discuss, the ways in which your selected organisation:
· Recruits and inducts new staff
· Manages staff performance and engagement
· Identifies and advances high performing staff
· Ensures that staff operate safely
· Advances a diversity agenda across its staff and management base
· Encourages staff to stay at the organisation
· Resolves disputes and/or negotiates pay and benefits
In the second part of the assignment (approximately 1100 words in length) you should offer informed suggestions, supported by peer-reviewed academic literature (i.e. quality journal articles) on how the organisation can better structure its HRM practices and policies to advance employee performance (such as engagement, wellbeing, safety, commitment etc.) and organisational outcomes (e.g. profit and standing). Your suggestions should be critical and based on evidence, and at least 8 peer-reviewed academic articles should be cited in this section.
Home-based exergaming among children with
overweight and obesity: a randomized clinical trial
A. E. Staiano , R. A. Beyl , W. Guan , C. A. Hendrick , D. S. Hsia and
R. L. Newton Jr.
Pennington Biomedical Research Center, Baton
Rouge, Louisiana, USA
Address for correspondence:
AE Staiano, Pennington Biomedical
Research Center, 6400 Perkins Rd,
Baton Rouge, LA 70815, USA.
E-mail: [email protected]
Received 14 February 2018; revised 30 April 2018;
accepted 26 May 2018
Summary
Background: Given children’s low levels of physical activity and high
prevalence of obesity, there is an urgent need to identify innovative physical activity
options.
Objective: This study aims to test the effectiveness of exergaming (video
gaming that involves physical activity) to reduce children’s adiposity and improve
cardiometabolic health.
Methods: This randomized controlled trial assigned 46 children with
overweight/obesity to a 24-week exergaming or control condition. Intervention par-
ticipants were provided a gaming console with exergames, a gameplay curriculum
(1 h per session, three times a week) and video chat sessions with a fitness coach
(telehealth coaching). Control participants were provided the exergames following fi-
nal clinic visit. The primary outcome was body mass index (BMI) z-score. Secondary
outcomes were fat mass by dual energy X-ray absorptiometry and cardiometabolic
health metrics.
Results: Half of the participants were girls, and 57% were African–American.
Int ...
Cardiovascular Response to Video Game: EyeToy Kinetic
Marissa Menendez Major Nutrition Project presentation 1-30-15
1. Investigating the relationship
between subjective and
objective exertion during a
cardiovascular fitness test in
minority obese youth
Presented by: Marissa Menendez
Major Professor: Dr. Kathryn Brogan
2. Introduction
Adolescent (12-19 yrs.) obesity rates have 5% -
18% in last 30 years. (Ogden et. al., 2012)
Obesity rates as high as 21% in non-Hispanic
black adolescents. (Ogden et al., 2012)
Physical activity (PA): engaging in bodily
movements that increase heart rate & breathing
difficulty (aerobic).
PA Guidelines for adolescents (12-17 yrs.) :
Aerobic – moderate (M) (50-70% HR Max) to
vigorous (V) (70-85% HR Max) intensity ≥ 60
minutes daily, including VPA at least 3 days/week.
3. What % of adolescents (12-15 yrs.) engaged
in moderate-to-vigorous PA for ≥ 60
minutes/day?
SOURCE (16): CDC/NCHS, National Health and Nutrition Examination Survey and National Youth
Fitness Survey, 2012.
4. Introduction
PA levels of ≥60 minutes are lowest in
adolescent females compared to
males and in African Americans
compared to Caucasians. (Kann et al., 2014)
Physical inactivity during adolescence
is a strong predictor of sedentary
adulthood. (Alfano et al., 2002)
5. Benefits of Moderate-Vigorous
PA
MVPA in youth can : BMI,1,2 body fat
%,1 waist circumference,2,3 stress/pain
perceptions. 4
AND Improve: several obesity-related
conditions2 depressive symptoms,4
sleep patterns,4 physical
competence,5 body satisfaction,5
cardiovascular fitness & exercise
tolerance.6
1. Reinher et al., 2010, 2. Reinehr et al., 2009, 3. Sykes et al., 2004, 4.
Gerber et al., 2014
6. Does engagement in moderate-to-vigorous PA
among 12-15 yr. old youth differ by weight
status?
SOURCE (16): CDC/NCHS, National Health and Nutrition Examination Survey and National Youth Fitness
Survey, 2012.
7. Subjective vs. Objective
Exertion
Rate of perceived exertion (RPE):
subjective measure of exercise
intensity that can safely regulate
exercise intensities in non-clinical
settings (Borg’s 6-20 RPE scale).
(Buckley et al., 2004)
Objective exertion: actual heart rate
(HR) values can be use to regulate
exercise intensities via HR monitor.
(Buckley et al., 2004; Conley et al., 2011; McManus et al., 2008)
8. Literature Review
Children and adolescents vary widely in their
abilities to rate their perceived exertions during
physical activity, even with HR biofeedback.
(Conley et al., 2011; McManus et al., 2008)
Youth commonly over-or-underestimate their
actual (objective) exertion during MVPA. (Pianosi
et al., 2014)
Children and adolescents lack the prior
experiences and PA perceptions to accurately
gauge the varying amounts of perceived
exertion at different intensities of exercise.
(Huebner et al, 2014)
9. Significance
There is limited research on subjective
(RPE) and objective (HR) exertion levels
in African American obese youth.
Adolescents who are able to successfully
associate their subjective and objective
exertion may be better able to properly
regulate their exercise intensities during
PA & effectively achieve PA
recommendations.
10. Aim 1
Aim
• To describe the subjective exertion (Borg’s
Scale of RPE) and objective exertion (heart
rate) in African American adolescents with
obesity (AAAO) performing a fitness test.
Analysis
• SPSS 21.0; p < 0.05 statistically significant
• Descriptive statistics (min./max., range,
mean, standard deviation) were used to
describe objective (heart rate) and
subjective exertion (Borg’s 6-20 scale of
RPE) at each fitness level
11. Aim 2
Aim
• To investigate the relationship between subjective
exertion (Borg’s Scale of RPE) and objective
exertion (heart rate) in AAAO performing a fitness
test.
Hypoth
• A weak relationship exists between subjective
exertion and objective exertion in obese African
American adolescents performing a fitness test.
Analysis
• Linear regression, ANOVA & standardized
coefficient beta were used to analyze the
relationship between HR and RPE.
12. Aim 3
Aim
• To examine the effects of the age, gender, BMI, body fat
percentage, waist circumference and presence of co-
morbidities, on subjective exertion (Borg’s Scale of
RPE) and objective exertion (heart rate) in AAAO
performing a fitness test.
Hypoth
• Older youth, males and youth with lower BMI, body fat
%, waist circumference and fewer co-morbidities will
have a stronger relationship between subjective and
objective exertion during a fitness test
Analysis
• Multiple linear regression, ANOVA and simple slopes
test were used to examine how the moderator variables
affect the relationship between subjective and objective
exertion.
13. Methods
Parent Study: FIT
Families Project: 6 month
behavioral weight loss
study
181 Obese African
American
adolescents 12-16
years old
Baseline data,
anthropometrics,
CST
All parent study
data de-
identified, using
patient IDs; IRB
Secondary
analysis of
cardiovascular
fitness test
14. Chester Step Test
(CST) Methods
5 stages, 2 minutes each, tempo
begins at 15 steps/min. increasing 5
steps/min. each successful stage; 12
inch step
HR Max & 80% HR Max calculated
HR monitor e-pulse display and
sensor
Demonstration/explanation of CST &
stepping technique to metronome
15.
16. Chester step test: Instructions &
Flow
Adolescent
steps to pre-
recorded
metronome
beat on CD for
2 min.
HR & RPE
recorded
during last 3
seconds of
each stage
Adolescent
reaches ≥ 80%
HR Max and/or
reports RPE
≥14
CST STOPS:
Final step level
completed,
HR/RPE
recorded
CST continues to each
successive stage if HR
Max <80% & RPE <14
18. Aim 1 Results: Describing the subjective &
objective exertion of African American obese
adolescents
55%
17%
23%
5%
Frequency of Causes for Stopping CST at all
ages 12-16: Levels 1-5
RPE
HR
Both
Neither
19. Frequency of Causes for Stopping
CST Levels 1-5: Ages 12-16
66%
10%
22%
2% Age 12
RPE
HR
Both
Neither
56%
18%
20%
6%
Age 13
47%
31%
19%
3%
Age 14
44%
13%
38%
5%
Age 15
62%14%
14%
10%
Age 16
21. Aim 2 Results: Relationship between
subjective and objective exertion
Regression Model Summary
R R2 Adjusted R St. Error of
Estimate
.134a .018 .012 2.038
Coefficientsb
Unstanda
rdized
Coef.
Standardi
zed Coef.
B St. Error Beta t Sig.
Constant 17.177 1.400 12.270 0.000
HR at
complete
d step
level
-0.016 0.009 -0.134 -1.790 0.075
a. Predictors: (Constant), HR Heart rate at completed step level
b. Dependent Variable: RPE Rate of perceived exertion at
completed step level
22. Aim 3 Results: Which variables affect the
relationship between subjective & objective
exertion?
Regression Model Summary
Variables
R R2
Adjusted
R2
Std. Error
of the
Estimate
St.
Coef.
Beta
t Sig.
Age .135 .018 .001 2.049 -.019 -.246 .806
Gender .144 .021 .004 2.047 -.057 -.549 .584
BMI .178 .032 .015 2.035 .107 1.359 .176
Waist
Circ.
.181 .033 .016 2.034 .087 1.124 .263
Co-
morb.
.150 .023 .006 2.045 .030 .284 .777
Body fat
%
.234 .055 .038 2.020 .170 2.255 .025
Dependent Variable: RPE at completed step level
Predictor Variables: HR at completed step level X moderator variables
23. Body fat % moderates the relationship
between subjective & objective exertion
16
16.2
16.4
16.6
16.8
17
17.2
17.4
17.6
17.8
18
Low HR High HR
RPE
Low % Body Fat
High % Body Fat
Among adolescents with higher % body fat, the higher the actual heart rate, the
higher the RPE score.
Among adolescents with lower % body fat, the higher the actual heart rate, the lower
the RPE score.
24. Summary
AIM1: Overall, 55% of
adolescents stopped the CST
because of their perceived
exertion ≥14, 17% for objective
exertion, 23% matched.
AIM 2: Subjective exertion and
objective exertion were
marginally related (beta = -
0.134)
AIM 3: Body fat % was the only
moderator variable to
significantly affect the strength in
relationship between subjective
and objective exertion
25. Discussion
Borg’s 6-20 scale of RPE extensively
used in CST, although OMNI &
Dalhousie pictorial scales may be more
appropriate for youth. (Pianosi, 2014; Barkley,
2011; Elliott, 2008; Alves de Camargo, 2011)
With/without HR biofeedback youth
over-and-under estimate time spent in
MVPA, but higher % overestimate. (Conley
et al., 2011)
Limited evidence on how body fat %
moderates the relationship between HR
and RPE – fitness levels could be
27. Conclusion
Adolescents need to be well-trained to
identify their exercise intensities to
appropriately self-regulate their PA to
achieve recommended guidelines of ≥
60 minutes of MVPA daily, including VPA
≥ 3 days/wk. (Physical Activity Guidelines, 2008).
Youth could greatly benefit from
dietitians assisting them in accurately
identifying MVPA and closely matching
subjective & objective exertion, to
successfully overcome this barrier.
28. Implications for Dietetic Practice:
AND
Weight management interventions combining
PA, dietary intake/nutrition education,
behavior counseling & caregiver engagement
have achieved successful outcomes in
overweight and obese adolescents (Reinehr et al.,
2010; Covelli, 2008; Hoelscher et al., 2013)
Nutrition professionals: role/responsibility to
utilize nutrition & PA recommendations to
promote and maintain optimum health
throughout the lifecycle. (Fitzgerald and Slawson, 2013)
RDs need adequate training/skills for
challenges of child-obesity epidemic:
assessment of body size, diet & PA;
knowledge of weight management strategies
29. Future Research
Culturally targeted long-term interventions
needed for different types and intensities of
exercise in African American obese
adolescents. (Zoorob et al., 2013)
Research investigating the effects of age,
gender, BMI, waist circumference, co-
morbidities & body fat % on RPE & HR
during different physical activities.
Investigating the PA knowledge/skills of
nutrition professionals and implementation
strategies of the youth physical activity
recommendations (utilization of the AND PA
toolkit for RDs).
30. Thank You!
Dr. Brogan
Dr. Tiura
Family
A Teacher Affects Eternity. She can
never tell where her influence
stops.
Author Unknown
Exercise is King, Nutrition is Queen.
Put them together and you have a
Kingdom! Jack Lalane
31. References
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and trends in body mass index among US children and adolescents.
JAMA. 2012;307:483-490.
2. Kann L, Kinchen S, Shanklin SL et al. Youth risk behavior
surveillance — United States, 2013. MMWR. 2014;63(4):35-36.
3. Alfano, CM, Klesges, RC, Murray, DM, Beech, BM, &
McClanahan, BS. History of sport participation in relation to obesity
and related health behaviors in women. Preventive Medicine.
2002;34(1):82-89.
4. Reinehr T, Kleber M, Toschke AM. Lifestyle intervention in obese
children is associated with a decrease of the metabolic syndrome
prevalence. Atherosclerosis. 2009;207(1):174-180.
5. Reinehr T, Schaefer A, Winkel K, Finne E, Toschke AM, Kolip P.
An effective lifestyle intervention in overweight children: Findings
from a randomized controlled trial on “Obeldicks light”. Clinical
Nutrition. 2010;29(3):331-336.
6. Gerber M, Brand S, Herrmann C, Colledge F, Holsboer-Trachsler
E, Pühse U. Increased objectively assessed vigorous-intensity
exercise is associated with reduced stress, increased mental health
and good objective and subjective sleep in young adults. Physiol
32. References
7. Luszczynska A, Abraham C. Reciprocal relationships
between three aspects of physical self-concept, vigorous
physical activity, and lung function: A longitudinal study
among late adolescents. Psychol Sport Exerc.
2012;13(5):640-648.
8. Silva DAS, Petroski EL, Pelegrini A, Guglielmo LGA. Effect
of physical exercise on the cardiorespiratory response in
overweight adolescents. Turkish Journal of Endocrinology
and Metabolism. 2012;16:14-18.
9. Healthy People 2020 Topics and Objectives: Physical
Activity. U.S. Department of Health and Human Services.
http://www.healthypeople.gov/2020/topicsobjectives2020/over
view.aspx?topicid=33. Updated June 9, 2014. Accessed June
9, 2014.
10. Physical Activity Guidelines Advisory Committee: Physical
activity guidelines advisory committee report. U.S.
Department of Health and Human Services.
http://www.health.gov/PAGuidelines/Report/pdf/CommitteeRe
port.pdf. Published 2008. Accessed June 9, 2014.
11. Morris M, Lamb K, Cotterrell D, Buckley J. Predicting
maximal oxygen uptake via a perceptually regulated exercise
test (PRET). Journal of Exercise Science & Fitness.
2009;7(2):122-128.
33. References
12. Pianosi PT, Huebner M, Zhang Z, McGrath PJ. Dalhousie
dyspnea and perceived exertion scales: Psychophysical
properties in children and adolescents. Respiratory Physiology &
Neurobiology. 2014;199(0):34-40.
13. Buckley JP, Sim J, Eston RG, Hession R, Fox R. Reliability
and validity of measures taken during the chester step test to
predict aerobic power and to prescribe aerobic exercise. Br J
Sports Med. 2004;38:197-205.
14. Sykes K, Roberts A. The chester step test—a simple yet
effective tool for the prediction of aerobic capacity.
Physiotherapy. 2004;90(4):183-188.
15. Conley MM, Gastin PB, Brown H, Shaw C. Heart rate
biofeedback fails to enhance children's ability to identify time
spent in moderate to vigorous physical activity. Journal of
Science and Medicine in Sport. 2011;14(2):153-158.
16. Fakhouri THI, Hughes JP, Burt VL, et al. Physical activity
in U.S. youth aged 12–15 years, 2012. NCHS data brief, no
141. Hyattsville, MD: National Center for Health Statistics.
2014. http://www.cdc.gov/nchs/data/databriefs/db141.htm.
Accessed September 6, 2014.
34. References
17. Cook S, Auinger P, Huang TTK. Growth Curves for Cardio-
Metabolic Risk Factors in Children. J Pediatr. 2009;155(3): S6.e15–
S6.e26.
18. Huebner M, Zhang Z, Therneau T, McGrath P, Pianosi P. Modeling
trajectories of perceived leg exertion during maximal cycle
ergometer exercise in children and adolescents. BMC Medical
Research Methodology. 2014;14(4):1-9.
19. Fitzgerald N., Slawson D. Practice paper of the Academy of
Nutrition and Dietetics: The Role of Nutrition is Health Promotion
and Chronic Disease Prevention. J Acad Nutr Diet. 2013:1-13.
20. Barkley JE, Roemmich JN. Validity of a pediatric RPE scale when
different exercise intensities are completed on separate days.
Journal of Exercise Science & Fitness. 2011;9(1): 52-57
21. Elliott D, Abt G, Barry T. The effect of an active arm action on heart
rate and predicted VO2max during the Chester step test. Journal of
Science and Medicine in Sport. 2008;11(2):112-115.
22. Alves de Camargo A, Justino T, Silva de Andrade CH, Malaguti C,
Dal Corso S. Chester step test in patients with COPD: Reliability and
correlation with pulmonary function test results. Respiratory Care.
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23. Hoelscher DM, Kirk S, Ritchie L, Cunningham-Sabo L. J Acad Nutr
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Overweight and Obesity. 2013;113(10):1375-1394.
36. Descriptive Statistics: CST
N Minimum Maximum Mean
Std.
Deviation
Aerobic
Capacity
(mlsO2/kg/
min)
178 17 67 31.70 9.975
Fitness
Rating 178 1 5 4.01 1.107
Step level
completed 178 1 5 1.98 .770
HR at
completed
step level
(bpm)
178 78 197 157.99 17.393
RPE at
completed
step level
178 8 20 14.69 2.051
Chester
step test
validity
166 1 2 1.01 .078
Fitness Rating: 1 = Excellent, 2 = Above Average, 3 = Average, 4 = Below
Average, 5 = Poor
Borg’s RPE Scale: 6 = Very, Very Light; 20 = Exhaustion
Chester step test validity: 1 = Valid, no reason for concern; 2 = Uncertain, some
reason for concern
37. 80% Age-predicted HRMax
Age 12
Max HR = 208bpm
80% Max HR: 166bpm
Age 13
Max HR 207bpm
80% Max HR: 166bpm
Age 15
Max HR = 205bpm
80% Max HR:
164bpm
Age 14
Max HR = 206bpm
80% Max HR:
165bpm
Age 16
Max HR = 204bpm
80% Max HR:
163bpm
39. Aim 2 Results: Relationship between
subjective and objective exertion
ANOVAb
Sum of
Squares
df Mean
Square
F Sig.
Regressi
on
13.313 1 13.313 3.205 0.075a
Residual 731.069 176 4.154
Total 744.382 177
a. Predictors: (Constant), HR Heart rate at completed step level
b. Dependent Variable: RPE Rate of perceived exertion at completed step
level
40. Aim 3 Results: Which variables affect the
relationship between subjective & objective
exertion?
ANOVAa
Variables Sum of
Squares df
Mean
Square F Sig.
Age Regression 13.579 3 4.526 1.078 .360b
Residual 730.804 174 4.200
Gender Regression 15.341 3 5.114 1.220 .304b
Residual 729.041 174 4.190
BMI Regression 23.649 3 7.883 1.903 .131b
Residual 720.733 174 4.142
Wst Circ. Regression 24.413 3 8.138 1.967 .121b
Residual 719.969 174 4.138
Co-morb. Regression 16.817 3 5.606 1.341 .263b
Residual 727.565 174 4.181
BF % Regression 40.820 3 13.607 3.335 .021b
Residual 701.719 172 4.080
a. Dependent variable: RPE at completed step level
b. Predictor variables (constant): HR at completed step level X moderator variables
Moderate Intensity: 50-70% of their age predicted HR Max
Vigorous Intensity: 70-85% of the age predicted HR Max
1. Includes physical activities both in school and outside of school.
2. Boys: 27.0% engaged in moderate-to-vigorous physical activity for at least 60 minutes daily (7), compared to 22.5% of girls.
3. Boys: 6.4% did not engage in moderate-to-vigorous physical activity on any day of the week (0) compared to 8.7% of girls.
4. Differences of PA between boys and girls is not statistically significant.
Borg’s scale visual
Recommendations: Children and adolescents should include muscle strengthening exercises 3 days/week
There are several obesity related conditions….such as hypertention, diabetes, hyper lipidemia, high triglycerides, sleep apnea
1. Boys: 29.5% of normal-weight and 29.5% of overweight individuals engaged in moderate-to-vigorous physical activity on every day of the week for at least 60 minutes compared with 18.0% of obese boys* - Boys had a greater difference in obese and overweight PA compared to girls**
2. Girls: 24.1% of normal-weight, 20.1% of overweight, and 19.6% of obese individuals engaged in moderate-to-vigorous physical activity on every day of the week for at least 60 minutes.
3. Differences in physical activity among normal weight, overweight and obese boys and girls, respectively was not significant.
Excess weight decreases boys physical activity and not girls.
Coefficient: p value
Meet with weight loss counselor at home or weight management center 2x/wk & RD 2x for 3 months
Adolescents at ≥3% weight loss reduce frequency of WLC & others in contingency management rewards system
7 month study completion: data & blood collection, anthropometrics, CST
A BMI of 38 even if we put it on the adult scale is a very high level of obesity
In analyzing the overall frequency of causes for stopping the Chester step test, it is evident that more than half (55%) of the adolescents halted the test as a result of their RPE being 14 (Borg’s 6-20 RPE scale) and 17% of adolescents stopped because their HR reached 80% of their age predicted HRMax. Less than a quarter (23%) of adolescents had to stop the test because their RPE was 14 and heart rate reached 80% of their age predicted HRMax, leaving only 5% quitting because of neither heart rate nor RPE.
12 yr. olds had the highest frequency of stopping because of RPE (66%) and 15 yr old adolescents had the lowest frequency of stopping for RPE (44%) but the highest frequency for ending because both their HR and RPE reached the allowable thresholds for the Chester step test (38%). Adolescents at age 14 were the group that most frequently terminated the Chester step test because of reaching 80%HRMax values (31%).
Age 12: n=41
Age 13: n=45
Age 14: n=32
Age 15: n=39
Age 16: n=21
47 (26%) adolescents stopped the Chester step test at Stage 1, after only 2 minutes of stepping; 70% of them halting the test because their RPE reached 14 and 9% because both HR and RPE reached the designated threshold of 80%HRMax and 14, respectively.
Over half of the 178 participants (n = 93, 52%) terminated the Chester step test at Stage 2, after 4 minutes of stepping, most commonly because of their RPE elevating to 14. Almost 1/3 of the adolescents (29%) had a HR value and RPE that both matched the established thresholds for terminating the test. Results indicated only 17% of adolescents had to stop the test because their HR reached 80% HRMax.
33 adolescents completed the Chester step test at stage 3, with 55% because of RPE and 30% because their HR and RPE both reached the cut-off values for test termination; leaving only 12% stopping because of HR and 3% because of neither HR nor RPE
Only 4 adolescents (Age 13, 14, and two 15 years old) successfully completed stage 4, 8 minutes of stepping. Half of them stopped because of RPE, leaving one quarter each because of HR reaching 80% HRMax and both HR and RPE reaching termination values
Only 1 obese adolescent, age 12, was able to successfully complete all five stages of the Chester step test. The HR of this adolescent (169 bpm) surpassed the 80%HRMax of 166 bpm but the RPE of 12 remained below the threshold, signifying a “fairly light” rate of perceived exertion
***97% (173) of adolescents could not progress to CST stages 4 & 5, completing only 6 minutes of stepping.
1. The linear regression model analysis demonstrates that HR at completed step level is able to predict 1.8% of the variance in RPE values
2. A trend towards a weak (marginal) relationship exists between HR at completed step and RPE at completed step level (F=3.205, p = 0.075, Beta = -0.134), not statistically significant.
3. Standardized beta explains the strength and direction of the relationship between HR and RPE.
As HR at completed step level increases by 1 SD, RPE decreases by 0.134, although HR is not a statistically significant predictor of RPE.
Multiple regression model affirms age (p = 0.806), gender (p = 0.584), BMI (p = 0.176), waist circumference (p = 0.263) and presence of co-morbidities (p = 0.777) do not affect the relationship between HR at completed step level and RPE at completed step level. Body fat was the only variable that significantly moderates the relationship between HR and RPE at completed step level. (Regression, p = 0.025). A one standard deviation increase in HR at completed step level interacting with body fat (bodyfatXhr) leads to a 0.170 increase in RPE at completed step level (Beta = 0.170).
The 2 way standardized plot and simple slopes test revealed that among adolescents with higher % body fat, the higher the actual heart rate, the higher the RPE score (p = 0.033). Conversely, among adolescents with lower body fat %, the higher the actual heart rate, the lower the RPE score (p = 0.020).
Perhaps the youth are more fit obese kids, that are in many activities-
Body fat % gives us a better sense of fitness compared to BMI
AIM 3 UNSUPPORTED for: age, gender BMI, waist circumference and presence of co-morbidities
This allows us to visually compare HRMax, exercise intensity and RPE.
As you can see light intensity signifies a HRMax range of 35-54% and an RPE of 10-11.
Moderate Intensity correlates with a HR Max ranging from 55-69% and an RPE of 12-13.
Hard (vigorous range) intensity with a HRMax of 70-89% correlated with an RPE of 14-16.
In the Chester step test, the adolescents continued stepping until they reached a HRMax of 80% or RPE of 14 (both in HARD range).
Therefore the CST is a sub-maximal exercise test in which participants remain in the low---moderate intensity most of the time.
As you can see from the chart, the adolescents on average completed only Chester step test stages, which is only 4 minutes in total.
The mean HR of the adolescents was 157.99 bpm and the RPE 14.69. The HR is only 77% of the HRmax for 12-16 year old adolescents even though the RPE reached the termination cut-off of ≥14.
The fitness rating of the adolescents was classified as below average.
The Chester step test was found to be a valid test (according to protocol), having no reason for concern.
47 (26%) adolescents stopped the Chester step test at Stage 1, after only 2 minutes of stepping; 70% of them halting the test because their RPE reached 14 and 9% because both HR and RPE reached the designated threshold of 80%HRMax and 14, respectively.
Over half of the 178 participants (n = 93, 52%) terminated the Chester step test at Stage 2, after 4 minutes of stepping, most commonly because of their RPE elevating to 14. Almost 1/3 of the adolescents (29%) had a HR value and RPE that both matched the established thresholds for terminating the test. Results indicated only 17% of adolescents had to stop the test because their HR reached 80% HRMax.
33 adolescents completed the Chester step test at stage 3, with 55% because of RPE and 30% because their HR and RPE both reached the cut-off values for test termination; leaving only 12% stopping because of HR and 3% because of neither HR nor RPE
Only 4 adolescents (Age 13, 14, and two 15 years old) successfully completed stage 4, 8 minutes of stepping. Half of them stopped because of RPE, leaving one quarter each because of HR reaching 80% HRMax and both HR and RPE reaching termination values
Only 1 obese adolescent, age 12, was able to successfully complete all five stages of the Chester step test. The HR of this adolescent (169 bpm) surpassed the 80%HRMax of 166 bpm but the RPE of 12 remained below the threshold, signifying a “fairly light” rate of perceived exertion
ANOVA also shows that body fat is the only variable found to significantly affect the relationship between HR and RPE at completed step level (p = 0.021).
Graphical analysis was used to obtain the aerobic capacity and fitness rating of the adolescents performing the Chester step test.
After the adolescent completed the CST, their HR at each of the completed level levels was plotted on a graph and a line was drawn to best fit the data points.
The line was further extended to cross the adolescent’s HRMax for their age. A vertical line was dropped down from this intersection to the correlated predicted aerobic capacity.
The norms for aerobic capacity table, for gender and age, was used to classify the predicted aerobic capacity by matching it to the corresponding fitness rating category including: excellent (1), good (2), average (3), below average (4), poor (5).