behavior change

Do exercise programs for kids really work?

October 17, 2012 By sh648 1 Comment

Nearly 12.5 million children – or 17 percent of the U.S. population ages 2-19 – are obese. As a response to this growing problem, schools and community groups have launched intervention programs designed to get kids moving. But do they work?

A new meta analysis published last month in the British Medical Journal was designed to answer just that question. It included 30 studies on exercise programs for children published worldwide between January 1990 and March 2012.

Studies in the review measured the effects of intervention programs that targeted children under 16 years old and lasted for at least four weeks. To be included, studies had to definitively measure levels of physical activity in children throughout the day – not just during the intervention class period – with devices like motion sensors.

In each case, the investigators expected that the programs would increase the children’s overall daily physical activity.

The review uncovered some surprising evidence: programs designed to encourage increased physical activity among kids didn’t work. On the whole, the programs increased children’s overall physical activity levels by about 4 minutes a day – even though the programs themselves ranged from 30 to 90 minutes in length.

One explanation is that children unconsciously compensate for the energy they use during structured activity programs by being doing sedentary activities aftewards, Brad Metcalf, a research fellow and medical statistician at Peninsula College who led the review, told the New York Times. Another explanation is that many of the programs took place after school, replacing a time period when children are typically most active anyway.

This analysis did yield some clear results: that we need to come up with additional strategies for encouraging physical activity among children.

Filed Under: Evidence-Based Living, Health and Wellness, Youth Development Tagged With: behavior change, children and youth, Health and Wellness, intervention research

What we know about car seats and how kids use them

August 21, 2012 By sh648 1 Comment

We have known for a long time that car seats save children’s lives. But even with that knowledge, do parents and caregivers use them appropriately?

A new study by researchers at University of Michigan found that while most people use child restraints properly, many do not. The researchers analyzed data on more than 21,000 children observed in cars at gas stations, fast-food restaurants, recreation centers and child care centers from 2007 to 2009 using guidelines from the American Academy of Pediatrics.

They found 21 percent of children ages 4 and younger were not following the recommendations for sitting in car seats. Thirty-three percent of 4- and 5-year olds and 66 percent of 6- and 7-year-olds were not following the recommendations for using car seats or booster seats. And – the most precarious finding – 11 percent of children were not wearing seat belts or sitting in car seats at all. Children were especially likely to be completely unrestrained if they were driving with an adult who wasn’t wearing a seat belt or if there were four or more children in the car.

While the evidence on kids using car seats is not encouraging, there are some intervention programs proven to increase the use of child safety seats. One systematic review found strong evidence that child safety seat laws increase the use of safety seats. Programs that combine education with distribution of car seats, incentives for installing car seats correctly and stepped up enforcement of laws also increase the use of car seats.

The bottom line: Car seats help save kids lives. It’s important to use them as recommended by the American Academy of Pediatrics.

Filed Under: Evidence-Based Living, Health and Wellness, Youth Development Tagged With: behavior change, children and youth, Health and Wellness, parenting, transportation

Move it or lose it: Real evidence on physical activity

July 31, 2012 By sh648 1 Comment

In honor of the 2012 London Olympics, the British medical journal The Lancet published a series of publications about the state of physical fitness across the globe.

The series includes a plethora of new evidence:

One large-scale report collected data on physical activity levels for adults 15 years or older from 122 countries worldwide. It found that more than 31 percent of adults are physically inactive. The researchers found that inactivity levels rise as people get older, and the women are less likely to be active than men. It also found that physical inactivity is more problematic in higher-income nations.

A far-reaching analysis in the series uses advanced statistical methods of quantify the health implications of physical inactivity on the major non-communicable diseases in 122 countries across the globe. The authors concluded inactivity was a contributing factor to heart disease, diabetes, breast cancer and colon cancer. The estimated that 9 percent of premature death across the word were related to physical inactivity.

Another article provides a comprehensive review of evidence-based strategies for promoting physical activity. The review found that community and mass media informational campaigns helped encourage people to get moving. It also found that schools and worksites are good venues for promoting physical activity through education, sports and social groups. Finally, the authors found that finding ways to encourage activity within a community – including building sidewalks, implementing policies that encourage active transportation and building parks and gyms – are all good ways to improve physical fitness.

While the Lancet provides a wide range of data about physical activity across the world, the take-home message is a simple one: It’s important to get moving, no matter what your age. Policy makers at all levels around the world should make it a priority to increase physical activity levels in their communities and countries.

Filed Under: Evidence-Based Living, Health and Wellness, policy Tagged With: behavior change, Community, Health and Wellness, policy, research translation

The science of political campaigns

July 17, 2012 By sh648 1 Comment

The 2012 presidential candidates will spend billions of dollars to encourage people to vote for them this year. Independent analysts currently estimate that President Barack Obama and Republican nominee Mitt Romney will spend more than $6 billion in their campaigns. But how do they really know that money will bring them votes?

It turns out there is an emerging cadre of researchers using scientific techniques – specifically the randomized controlled trial – to find out which campaign strategies actually bring people to the polls.

Among them are Todd Rogers, a behavioral psychologist at Harvard University, and David Nickerson, a political science professor at the University of Notre Dame. Together, they conducted a study in the 2008 Democratic primary in Pennsylvania that attempted to determine whether get-out-the-vote reminder calls made a significant difference in voter turnout.

For the study, Rogers came up with some questions that would ask people about their plans on voting day such as “What do you think you’ll be doing before you head to the polls on Tuesday?” and “Where do you think you’ll be coming from that day?” His theory – based cognitive psychology principles – was that these questions would plant a seed voters’ minds to helps them remember to vote.

The researchers used the questions in a randomized controlled trial. Some citizens received phone calls asking the questions, others received the standard get-out-the-vote call and others did not receive a phone call. They found a dramatic result: People who were asked the planning questions were twice as likely to vote as people who were not.

There are other examples of scientific studies applied to campaign strategies. Rogers and a colleague at Yale University found evidence that messages which tell people high turnout is expected are more effective at motivating voters than messages which emphasize low voter turnout.

And a review of field studies in get-out-the-vote campaigns found that many of these strategies improve voter turnout, but tend to mobilize well-represented groups of people and miss under-represented groups – effectively widening disparities in the electorate.

Here at EBL, we think it is great news that social scientists are applying scientific methods to the art of political campaigning – especially where so much money is involved. And we hope it’s information that candidates use in their campaigns.

Filed Under: Evidence-Based Living, In The Media Tagged With: behavior change, economics, evidence-based practice, policy, Politics, research translation, science in the media

Sitting all day is bad for your health

July 11, 2012 By sh648 2 Comments

We’ve all heard the messages about the importance of exercise. We know that as little as 45 minutes of activity four times a week can boost your heart health and energy, stave off depression and lead to stronger bones and joints. But does it matter what you do for the rest of the day?

New evidence says that it does.

A new systematic review published this week sought to answer the question, does prolonged periods of sitting lead to an earlier death? With so many people in desk jobs – tethered to computer monitors and spending free time in front of the television – it is an important question to ask.

The review looked at five separate studies that measured time spent sitting and mortality rates in the United States. The researchers adjusted for other variables including age, health status and physical activity. What they found is indeed surprising.

People who sat for prolonged periods on a regular basis were at a greater risk for an early death. Using a statistical model, the researchers found that people who sat for less than three hours a day increased their average life expectancy by about two years.

A separate study of more than 200,000 adults living in the southern hemisphere found that people who sat for more than 11 hours a day had a 40 percent higher risk of dying in the next three years compared to people who sat less than four hours a day. This study adjusted for other factors such as health status, age and physical activity levels. And it found a clear relationships between sitting and mortality rates. Essentially that means the more people sat, the higher their risk of death.

The take-home message for this one is pretty clear: get up and move. But what’s a person with a desk-job to do? Doctors say getting up for 10 minutes every hour can help. You can also invest in or make your own standing desk, which will allow you to do desk-work on your feet.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: behavior change, evidence-based practice, Health and Wellness, research translation

Bodyfat facts: Real evidence on the consequences of obesity

June 14, 2012 By sh648 2 Comments

We often hear in the media – this blog included – that obesity is an epidemic in the United States, and move straight to discussing solutions to the problem. But lately I’ve found myself wondering, what exactly are the health consequences of being overweight or obese?

So, of course, I went on a hunt to find some evidence. It turns out there are many. The Harvard School of Public Health provides a great summary of the health risks of obesity with references – many of them systematic reviews.

Their summary finds obesity associated most strongly with the diabetes and cardiovascular disease. Meta-analyses have found significantly greater risks of developing coronary artery disease, stroke and cardiovascular death.

While the link between obesity and cancer is less clear, there is certainly still ample evidence that shows obesity is a risk factor for developing cancers. A major review of the data by the World Cancer Research Fund and the American Institute for Cancer Research found evidence of an association between obesity and cancers of the esophagus, pancreas, colon and rectum, breast, endometrium, and kidney, and a probable association between obesity and gallbladder cancer. Since the report was released in 2007, the group is providing continuous updates about the evidence on diet, physical activity, body fatness and cancer.

There are other serious risks that come along with obesity: depression, dementia, infertility, asthma and arthritis.

I have to say that, personally, I was astounded by the sheer volume of evidence out there on the consequences of obesity. I know my fair share of people who are overweight. Reviewing the evidence bring their struggles into a whole new light for me. It doesn’t seem like you can live with obesity without some health consequence.

I did find one silver lining though. There is some pretty clear evidence in this report from the National Heart Blood and Lung Institute that losing some weight – even without reaching an ideal weight – offers some health benefits for adults who are obese. The clear take-home message here is to do what you can – eat more fruits and veggies, go for a walk, cut out junk food – to move toward a healthier weight.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: behavior change, Health and Wellness, nutrition

The link between happiness and health

May 3, 2012 By sh648 Leave a Comment

A positive mood can certainly make for a brighter day, but now there’s new evidence that is also makes for a healthier heart.

A systematic review by researchers at Harvard University looked at more than 200 studies on cardiovascular risks and emotional state – the largest ever reviewed in one paper. They found that patients who reported a positive mental state were less likely to suffer from heart disease and stroke.

Feeling such as optimism, happiness and hope seemed to protect against cardiovascular disease independently of risk factors like smoking and obesity.

While the link provides an interesting insight, it is difficult to tell whether happiness produces health, or whether healthier people are, by nature, happier. In either case, it’s prudent to cultivate a positive mindset.

At Cornell, psychologist Anthony Ong’s research focuses on how people maintain a positive attitude, even when they experience stressful events like the loss of a loved one. His work has shown that social connectedness – having a supportive relationships with those around you – contributes these daily positive emotions, and leads people to be more resilient in the face of adversity.

The take home message: Get out in your community and cultivate some good feelings!

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: aging, behavior change, Health and Wellness

Building and maintaining relationships is one key to healthy aging

April 30, 2012 By sh648 Leave a Comment

There are some clear risk factors that lead to an earlier death such as smoking, alcohol consumption and obesity. But are there other factors that influence health and wellness later in life – behaviors that researchers have yet to study?

Until recently, one of those unknown factors was social relationships. Anecdotal evidence suggested that people with strong social relationships reduced their risk of mortality, but there was little evidence to back up the suggestion. While many medical studies included a measure of social isolation, no one had looked at the issue on a broader scale.

That is, until researchers at Brigham Young University conducted a systematic review of the literature on how social relationships impact the risk of dying later in life. They reviewed 148 studies that included more than 300,000 participants that included information about how people died, their initial health status and pre-existing health conditions, as well as type of assessment of social relationships.

Over all the data they reviewed, they found a 50 percent increased likelihood of survival for participants with stronger social relationships. The lack of social relationships had more influence on mortality rates that other risk factors like physical activity and obesity.

The researchers noted that more complex measurements of social relationships – instead of simple indications such as marital status – were more predictive of death.

The take-home message is that your relationships later in life are just as important as what you eat and drink, how much exercise you get, and other important health behaviors. More research is needed to determine how relationships improve well-being, and specific characteristics that contribute to the trend. In the meantime, it’s important for medical professionals to consider social relationships in their treatment plans for older adults.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: aging, alternative treatments, behavior change, Community, Health and Wellness

New evidence on running shoes

April 10, 2012 By sh648 6 Comments

If you frequent a trail or neighborhood that is popular with runners, you’ve most likely noticed a new trend: people running barefoot or with very odd-looking shoes that place for each toe. And if you’re a runner yourself, you’ve certainly come across – maybe even experimented with – the trend of barefoot running.

Books like ChiRunning and Born to Run make the case for lower-profile, less-cushioned shoes or none at all. Here at EBL, we’ve written about the phenomenon before – specifically the work of Harvard biologist Daniel Lieberman, who studies the biomechanics of barefoot running and how early humans survived by evolving the ability to travel long distances to hunt.

Now a new study – detailed by a New York Times blog – has found that wearing light-weight shoes, instead of going completely barefoot, is metabolically more efficient.

The researchers’ argument goes something like this: Running with traditional running shoes, which weight 300 to 400 grams, increase the amount of energy required to run because with every step, the running is lifting those weights. Over the miles, that extra energy adds up.

For this study, researchers compared runners in lightweight shoes – weighing 150 grams – to barefoot runners who ran with leaded strips weighing 150 grams taped to the top of their feet. Carrying the same weight, the study found that barefoot running was actually less efficient compared to wearing light-weight shoes.

“What we found was that there seem to be adaptations that occur during the running stride that can make wearing shoes metabolically less costly,” Jason R. Franz, a doctoral candidate at the University of Colorado who led the study, told the New York Times. Shoes, he says, “provide some degree of cushioning.” If you eschew shoes, “something else has to provide the cushioning.”

Without any shoes, a runner’s leg muscles require additional energy to provide this cushioning.

In fact, the study even found that unweighted barefoot running was slightly less efficient than running with light-weight shoes, even though the shoes added weight.

The study didn’t address other benefits that barefoot runners tout – namely a reduction in injuries from running without shoes. But the study does make the case for investing in a different kind of running shoe – not the cushioned, bulky trainer that was once popular, but a more protective, lighter shoe that protects feet without adding weight.

Filed Under: Evidence-Based Living, Health and Wellness, In The Media Tagged With: behavior change, evidence-based practice, Health and Wellness, science in the media

What we know about mindfulness and meditation

March 29, 2012 By sh648 1 Comment

The phrase “living in the moment” is a buzz word in our modern society that denotes a life well-lived. With its roots lie in Buddhism, the idea of “mindfulness” and “living in the moment” has taken root in modern American culture.

From best-selling books like Eat, Pray, Love to yoga classes offered at nearly every gym in the country, the idea of living in the moment is en vogue. But does it really lead to a happier life?

A systematic review of the evidence found that mindfulness-based therapy – which encourages patients to focus on their breathing and their body, to notice but not judge their thoughts and to generally live in the moment – does yield positive benefits.

The review, published last year in the Journal of Consulting and Clinical Psychology, is focused on mindfulness as a treatment for psychological disorders. It looked at 39 studies involving 1,140 participants who received mindfulness-based therapy for a range of conditions including cancer, generalized anxiety disorder and depression.

The review concluded that mindfulness-based therapy somewhat helped ease the mental stress of people recovering from cancer and other serious illnesses. The treatment had the strongest benefits for people diagnosed with mood disorders, including generalized anxiety disorder and recurring depression.

That’s not to say that a daily meditation session can help cure severe depression or anxiety disorders, but it is a useful tool along with other treatment and for patient with more mild cases.

On a personal note, I don’t suffer from depression or mood disorders, but I do find that a few minutes spent focused on my breath and calming my mind helps me to focus and stay positive for the rest of the day. I find it’s a habit worth cultivating.

Filed Under: Evidence-Based Living, Health and Wellness, In The Media Tagged With: alternative treatments, behavior change, evidence-based practice, Health and Wellness, social trends

How your working environment impacts your health

March 6, 2012 By sh648 Leave a Comment

Adopting a healthy lifestyle can be tough these days, especially for parents working hard to make ends meet. Yes, there are gyms and organic grocery stores, on-demand yoga and healthy cooking magazines. But for working parents, long hours and irregular schedules make can make it difficult to eat healthily and exercise.

A cadre of researchers are Cornell’s College of Human Ecology are working on this problem, conducting the research and pulling together the best evidence to help families exercise more and eat healthier.

Among them is nutritional sciences professor Carole Devine, who has created and evaluated a program that helps change workplace environments to support physical activity and healthy eating.

The program, called Small Steps are Easier Together, is an active collaboration between Cornell faculty, Cooperative Extension educators and worksite leadership teams across New York. Pilot studies have been conducted in 23 sites since 2006. It involves worksites creating wellness leadership teams, who work with Cornell researchers to implement evidence-based strategies – like creating walking groups, posting maps, and offering more fruit and vegetable options in the cafeteria – to increase walking and promote healthier eating.

The most recent analysis of the program included 188 participants in 10 rural worksites. It found the percentage of sedentary women had declined to from 42 percent to 26 percent. A total of 35 percent of the women moved to a higher activity level.

Devine is also pulling together the evidence on how working conditions impact food decisions for families at home and on the job.

Her research has found that the stress of a busy job impacts parents’ ability to serve healthy meals, leading them to serve quicker and less healthy meals, such as fast food. She’s investigated a variety of coping strategies such as negotiating a more flexible work schedule and teaming up with a neighbor to take turns preparing meals.

Devine’s work highlights the connections between work environments and health, and provide some evidence-based strategies to improve public health.

Filed Under: Cornell Cooperative Extension, Evidence-Based Living, Health and Wellness Tagged With: behavior change, Cooperative Extension programs, environment, evidence-based programs, food and nutrition, Health and Wellness, intervention research, nutrition, parenting, research translation, social trends

Do exercise programs for kids really work?

What we know about car seats and how kids use them

Move it or lose it: Real evidence on physical activity

The science of political campaigns

Sitting all day is bad for your health

Bodyfat facts: Real evidence on the consequences of obesity

The link between happiness and health

Building and maintaining relationships is one key to healthy aging

New evidence on running shoes

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