•Backward walking (BW) training impacts balance performance.•BW relies more on senses other than the visual system compared with forward walking.•BW has additional biomechanical benefits over forward ...walking.•BW training can significantly improve balance performance and posture control.•It could serve as a potentially useful tool to improve balance performance.
Backward walking (BW) training is thought to impact balance performance through improving motor system proprioception and gait characteristic, but relevant evidence remains sparse and inconclusive.
This study systematically reviewed and quantified the scientific evidence regarding the effectiveness of BW training on balance performance.
Keyword and reference search on BW training interventions was conducted in six electronic databases (PubMed, Web of science, SPORTDiscus, CINAHL, Cochrane Library, and CNKI) for peer-reviewed articles published till November 2017. A standardized form was used to extract data from each selected article that met the pre-specified eligibility criteria. Meta-analysis was conducted to estimate the pooled effects of BW training on balance performance measures.
Eleven studies (nine randomized controlled trials and two pre-post studies) met the eligibility criteria and were included in the review. All studies reported some beneficial effects of BW training on balance performance. Compared to control, BW training was associated with a reduction in overall stability index score by 0.99 (95% CI = 0.37, 1.61; I2 = 0.0%; fixed-effect model), medial-lateral stability index score by 0.95 (95% CI = 0.34, 1.57; I2 = 0.0%; fixed-effect model), and anterior-posterior stability index score by 0.99 (95% CI = 0.37, 1.61; I2 = 0.0%; fixed-effect model). Meanwhile, BW training was associated with an increase in open-eyes single leg standing duration by 0.91 s (95% CI = 0.29, 1.53; I2 = 75.9%; random-effect model) in comparison to control.
BW training could serve as a potentially useful tool to improve balance performance among those with a high risk of fall. However, current evidence remains preliminary due to the small cohort of studies and possible learning effect in pre-post studies. Future work with larger scale and randomized experimental design is warranted to evaluate the effectiveness of BW training on balance performance across diverse population and disease subgroups, and elucidate the underlying biomechanical and neurological pathways.
Accurate, readily accessible, and easy-to-understand nutrition labeling is a promising policy strategy to address poor diet quality and prevent obesity.
This study projected the influence of ...nationwide implementation of sugar-sweetened beverage (SSB) warning labels and restaurant menu labeling regulations.
A stochastic microsimulation model was built to estimate the influences of SSB warning labels and menu labeling regulations on daily energy intake, body weight, body mass index, and health care expenditures among US adults.
The model used individual-level data from the National Health and Nutrition Examination Survey, Medical Expenditure Panel Survey, and other validated sources.
The model was simulated using the bootstrapped samples, and the means and associated 95% CIs of the policy effects were estimated.
SSB warning labels and restaurant menu labeling regulations were estimated to reduce daily energy intake by 19.13 kcal (95% CI 18.83 to 19.43 kcal) and 33.09 kcal (95% CI 32.39 to 33.80 kcal), body weight by 0.92 kg (95% CI 0.90 to 0.93 kg) and 1.57 kg (95% CI 1.54 to 1.60 kg), body mass index by 0.32 (95% CI 0.31 to 0.33) and 0.55 (95% CI =0.54 to 0.56), and per-capita health care expenditures by $26.97 (95% CI $26.56 to $27.38) and $45.47 (95% CI $44.54 to $46.40) over 10 years, respectively. The reduced per-capita health care expenditures translated into an annual total medical cost saving of $0.69 billion for SSB warning labels and $1.16 billion for menu labeling regulations. No discernable policy effect on all-cause mortality was identified. The policy effects could be heterogeneous across population subgroups, with larger effects in men, non-Hispanic Black adults, and younger adults.
SSB warning labels and menu labeling regulations could be effective policy leverage to prevent weight gains and reduce medical expenses attributable to adiposity.
The participants in the Supplemental Nutrition Assistance Program (SNAP) consume greater amounts of sugar and sweetened beverages (SSBs) compared to non-eligible individuals, which could result in ...potential negative health outcomes. This can be attributed to the lack of restrictions on SSB purchases with SNAP benefits. In view of the increasing calls from advocates and policymakers to restrict the purchase of SSBs with SNAP benefits, we performed a systematic review to assess its impact towards SSB purchases and consumption. We searched articles from five databases-Cochrane, EBSCO, SCOPUS, Web of Science, and PubMed-and selected seven studies, four of which were randomized controlled trials (RCTs) and three were simulation modeling studies. All three simulation studies and one RCT reported outcomes in terms of consumption, while the other three RCTs reported outcomes in terms of purchases. All seven studies found that an SSB restriction led to a decrease in SSB consumption or purchases, with six studies reporting significant results. Nonetheless, limitations exist. These include limited studies on this subject, potential workarounds circumventing SSB restrictions, like making purchases using personal cash, potentially differed estimated effects when combined with incentives or other initiatives, and the limited geographical scope among the selected RCTs.
Abstract
Social media holds the potential to engage adolescents and young adults and to facilitate interventions improving Human Papillomavirus Vaccine (HPVV). This article systematically reviewed ...the literature on Cochrane Library, PubMed, Web of Science, EMBASE, Scopus and CINAHL. Interventions delivered or facilitated by social media with outcomes of HPV-related knowledge, awareness, attitude, vaccination intention and behavior were included. Standardized forms were used to abstract the basic characteristics, settings, guiding theories and key findings of the interventions. Twenty-four studies met the eligibility criteria. Sixteen were educational interventions, and the other eight investigated the effect of social media message contents on improving Human Papillomavirus (HPV)-related outcomes. The studies were published between 2015 and 2021. The most frequently used social media platforms were Facebook, and the most commonly adopted theory was the health belief model (HBM). Existing interventions have shown preliminary but promising effects in improving HPV awareness and knowledge. Still, such improvements have not always been translated to improved behavioral intentions and vaccination rates. The contents and phrasing of social media messages and pre-existing individual characteristics of social media users moderated intervention effectiveness. Social media could be a valuable tool for engaging participants and delivering HPV interventions. Future interventions should apply stronger theory bases.
Abstract
Objectives
This study examined the longitudinal relationship between dietary habits and cognitive impairment among the oldest-old Chinese.
Method
Cognitively intact adults aged 80 or older ...(N = 4,749) came from the Chinese Longitudinal Healthy Longevity Survey. Cognitive impairment was assessed by Mini-mental State Examination. Cox regressions were performed to examine the relationship between dietary habits and cognitive impairment onset during follow-up period of 1998–2012, adjusting for various time-variant and time-invariant individual characteristics.
Results
Compared with those who rarely/never consumed fruit, vegetables, meat, and soybean-derived products, participants consuming such products almost every day were 21%, 25%, 17%, and 20% less likely to develop cognitive impairment during follow-up, respectively. Compared with those who rarely/never consumed sugar, participants consuming sugar almost every day were 17% more likely to develop cognitive impairment during follow-up. Consumption of fish, egg, salt-preserved vegetable, tea, and garlic was not found to be associated with cognitive impairment.
Discussion
Dietary habits might profoundly impact cognitive functioning among the oldest-old Chinese. This work has limitations pertaining to study design and measure. Future work adopting experimental design and refined dietary measures is warranted to confirm these findings and inform public nutrition practices aiming at preventing cognitive decline among the oldest-old Chinese population.
Pokémon Go is a popular mobile augmented reality game that requires players to travel to different locations to capture virtual characters. This study systematically reviews and quantifies Pokémon Go ...in relation to physical activity engagement among players.
A keyword search was conducted in PubMed, Web of Science, Scopus, EBSCO, SPORTDiscus, PsycINFO, ScienceDirect, and Cochrane Library for articles published between July 2016 and October 2018. Meta-analysis was performed to estimate the pooled effect of playing Pokémon Go on physical activity outcome.
From the keyword search, 17 studies (16 observational and 1 pre–post) were identified, with a total sample of 33,108 participants. A comparison between Pokémon Go players and nonplayers and between pre- and post-play time points revealed an increase in walking duration, distance walked, and number of steps/day. Pokémon Go players were also found to engage in less sedentary behavior. Playing Pokémon Go was associated with an increase in the number of steps per day by 1,446 steps (95% CI=953, 1,939; I2=81%).
Playing Pokémon Go was associated with a statistically significant but clinically modest increase in the number of daily steps taken among game players. One challenge for future physical activity interventions using Pokémon Go is to retain active engagement once the initial novelty wears off. Additional studies with longer follow-up periods and experimental study design are needed to assess to what extent Pokémon Go and other augmented reality games can be used to promote physical activity at the population level for a sustained time period.
This study examines the impact of a home-delivered meal program on daily energy and nutrient intakes using nationally representative data from the National Health and Nutrition Examination Survey ...2003–2012 waves. First-difference estimator addressed selection bias by using within-individual variations in diet and service use status between two nonconsecutive 24-hour dietary recalls among 145 home-delivered meal service users. Service use was found to be associated with a net increase in daily intake of protein by 8.39 g, fiber 3.39 g, calcium 145.94 mg, copper 0.16 mg, magnesium 45.37 mg, potassium 317.39 mg, selenium 14.04 mcg, and sodium 327.52 mg; whereas the effects on daily intake of total energy, fat, and vitamin D were not statistically significant. Home-delivered meals improve nutrient intakes among participants, but currently the program may be too limited in scale and capacity to best capitalize its beneficial impact on healthy aging and health care cost containment at the national level.
Backward walking training (BWT) is thought to affect gait biomechanics, but relevant evidence has been sparse and inconclusive.
This study systematically reviewed and quantified the effectiveness of ...BWT on spatial–temporal gait characteristics (STGC).
A keyword and reference search of interventions on BWT was conducted in five bibliographic databases: PubMed, Web of Science, SPORTDiscus, CINAHL, and Cochrane Library for articles published until November, 2017. Two reviewers independently screened titles, abstracts, and full texts of all articles and jointly decided the final pool. A standardized form was used to extract data from each included article. Meta-analysis was conducted to estimate the pooled effect of BWT on STGC.
Eleven studies met the eligibility criteria and were included in the review. All studies reported some positive influences of BWT on STGC relative to forward walking training (FWT) and/or control. Compared to FWT, BWT was associated with an increase in forward gait speed by 0.69 (95% confidence interval CI = 0.12, 1.25) m/s and stride length by 0.51 (95% CI = 0.22, 0.80) cm. Compared to control, BWT was associated with an increase in forward gait speed by 1.00 (95% CI = 0.36, 1.64) m/s.
BWT could improve participants’ STGC and be potentially useful in neurological rehabilitation. However, current evidence remains preliminary. The effects found could merely be due to differences in training intensity between the FWT and BWT, and thus, may not reflect actual differences between training in different walking directions. Future studies are warranted to elucidate the pathways linking BWT to gait biomechanics.
Purpose:
This study assessed the influence of state laws governing physical education (PE) on weekly PE class attendance among US high school students.
Design:
Cross-sectional.
Setting:
2003 to 2017 ...US national Youth Risk Behavior Survey (YRBS).
Participants:
A total of 533 468 high school students.
Measures:
Data on state laws governing PE came from National Cancer Institute’s Classification of Laws Associated with School Students (CLASS). Eight distinct state PE policies were scored, with higher scores denoting stronger laws.
Analysis:
Individual-level YRBS data were merged with CLASS data based on students’ residential state and survey year. State fixed-effect negative binomial regressions were performed, adjusting for individual-level characteristics and YRBS survey design.
Results:
A 1-score increase in state laws governing PE class time, staffing for PE, joint use agreement for physical activity, assessment of health-related fitness, and PE curriculum was associated with an increase in weekly PE attendance by 0.30, 0.28, 0.22, 0.20, and 0.13 days (P < .001), respectively. In contrast, a 1-score increase in state laws governing moderate-to-vigorous-intensity physical activity time in PE, PE proficiency, and recess time was associated with a reduction in weekly PE attendance by 0.25, 0.15, and 0.09 days (P < .001), respectively. The effects of most state PE policies on PE class attendance were larger among girls than boys.
Conclusion:
State PE policies differentially impacted US high school students’ PE class attendance, with larger effects on female students.
Highlights • There was an U-shaped association between body weight status and cognitive impairment in unadjusted data. • The unadjusted relationship between obesity and cognitive impairment appeared ...stronger among females. • Underweight was robustly associated with increased risk for cognitive impairment after adjustments.
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