Blood glucose management has progressed from diabetes treatment to tracking trends in healthy populations since the introduction of continuous glucose monitoring (CGM) in 1999. Previously, this population was difficult to study using traditional self-monitoring blood glucose (SMBG). This study aims to identify global research trends and synthesize existing findings regarding the impact of dietary and lifestyle factors on glycemic variability in healthy individuals. A Bibliometric-systematic literature review (B-SLR) was conducted by analyzing articles from the Web of Science database published between 1999 and 2025. Following a systematic screening process, 48 articles were selected for qualitative synthesis and categorized based on intervention types. The quality of the included studies was evaluated to ensure methodological rigor. The synthesis of 48 included studies revealed distinct behavioral clusters. Dietary interventions focusing on nutritional timing and composition (e.g., preloads and meal scheduling) consistently suppressed postprandial glucose spikes. Concurrently, physical activity interventions, particularly timed postprandial exercises, effectively minimized glycemic excursions. These fragmented lifestyle factors were successfully integrated into a comprehensive four-quadrant typology (Types I–IV) evaluated by intervention rigor and data continuity. The proposed novel four-quadrant typology successfully bridges fragmented lifestyle factors, revealing critical longitudinal gaps and providing an original, standardized framework to guide future research toward personalized behavioral interventions, technology-driven lifestyle modifications, and health optimization in healthy populations.
The complementary feeding period, from 6 to 23 months of age, is a critical window for healthy growth and malnutrition prevention, making accurate measurement of caregiver practices essential. However, existing instruments have primarily focused on dietary intake or feeding style and often neglected broader aspects of the feeding process, such as the feeding environment and hygiene practices, despite their documented importance for child nutrition. This study aimed to develop and validate a multidimensional instrument for assessing complementary feeding practices among infants and young children. Domains were informed by the best-practice complementary feeding behaviors framework, a literature review, and a two-round Delphi process with 31 experts. The draft questionnaire was pretested and administered in a validation survey of 556 caregiver–child dyads with children aged 6–23 months, recruited through multistage sampling in rural Sichuan, China. Item screening was conducted using both classical test theory and item response theory. Exploratory factor analysis identified the latent structure, and confirmatory factor analysis evaluated structural validity. Reliability was assessed using Cronbach’s α and split-half reliability coefficients. Indicator weights were derived by combining Delphi-based subjective weights with entropy-based objective weights. The two Delphi rounds demonstrated high expert authority coefficients (0.89 and 0.90) and improved consensus (Kendall’s W from 0.10 to 0.19, P < 0.001). The finalized instrument comprised four domains: dietary quality, feeding style, feeding environment, and feeding hygiene, and seven factors: appropriate complementary feeding (7 items), avoidance of unhealthy food and beverage consumption (3 items), avoidance of controlling feeding practices (9 items), restriction of unhealthy food and beverage provision (3 items), guided feeding practices (3 items), eating environment (3 items), and hand hygiene (3 items). Confirmatory factor analysis provided evidence of acceptable structural validity, with adequate model fit indices (GFI = 0.920, CFI = 0.903, TLI = 0.917, RMSEA = 0.038, SRMR = 0.046), and internal consistency was acceptable (overall Cronbach’s α = 0.78; split-half reliability coefficient = 0.77). Weight determination analysis indicated that dietary quality had the highest domain weight (0.319), followed by feeding style (0.272), feeding hygiene (0.240), and feeding environment (0.169). This newly developed instrument provides a reliable and comprehensive assessment of complementary feeding practices, extending beyond dietary intake to encompass feeding style, environment, and hygiene. It may support more precise assessment and inform targeted interventions, although further validation in diverse populations and settings is warranted.
Healthy Stores 2020 (HS2020), a 12-week randomised controlled trial conducted in partnership with an Aboriginal-owned retail organisation, reduced retailer merchandising and store-level purchases of unhealthy foods. Evidence on the influence of customer-level factors (e.g., sociodemographic and shopping behaviour) on unhealthy food purchases in remote Aboriginal and Torres Strait Islander communities is limited. This study of secondary outcomes from HS2020 aimed to determine: (1) Customer-level factors associated with no discretionary, and no free sugar purchases within a food shop; and (2) whether these factors modified response to the HS2020 strategy. A customer intercept survey with collection of transaction data was conducted in the 20 HS2020 participating stores (10 HS2020 strategy; 10 control). Number of items purchased and dollars spent on discretionary and free sugar products was obtained by linking receipt data to a food composition database. Outcomes were discretionary and free sugar purchases per transaction. Robust Poisson regression models estimated associations between outcomes, treatment group, and customer-level factors, with interaction terms to assess effect modification. Statistical significance was set at p < 0.01. The analysis included 783 participants – 87.4
Scaling up evidence-based effective interventions is essential to improve health-promoting practices in Early Childhood Education and Care (ECEC) settings. In this study, we investigated the scale-up of SuperFIT, an integrated intervention approach to promote healthy eating and regular physical activity (PA) in preschool children, via the ECEC and home setting. SuperFIT has already been disseminated to 85 ECEC locations in one region, and is now entering a new phase of scale-up to a different region. To ensure effective implementation, knowledge and expertise needs to be transferred to a new local provider. This study examined SuperFIT’s scale-up, by identifying facilitators, barriers and co-creating strategies to tackle barriers. We applied the PRACTIS guide and principles of Design Thinking to guide the study. This involved characterizing the implementation setting, engaging key stakeholders, identifying facilitators and barriers to scale-up, and co-creating strategies. Multiple stakeholders (N = 14) involved in the scale-up participated in semi-structured individual interviews and/or group sessions. Interview data and the first group session were analysed using a combined deductive-inductive approach, with a predefined framework guiding the analyses while allowing for additional themes to emerge from the data. Notes from the other two group sessions were subsequently reviewed to verify the emerging themes. Facilitators and barriers of upscaling existed at four levels: intervention, provider, organizational, and community. Adaptability emerged as the central factor influencing scale-up. At the intervention level, it allowed alignment with ECEC needs but raised fidelity concerns. At the provider level, limited experience with an adaptable intervention posed challenges. Organizational structures, responsibilities, and community level considerations (e.g., costs), are also influenced by adaptability. For each barrier, a strategy was co-created, for example providing guidance for new providers working with the adaptable approach. The PRACTIS guide proved to be a valuable tool, and our reporting on using the PRACTIS guide can help others in planning for scale-up in ECEC. The findings from this study provide a path forward, toward further scaling up SuperFIT to new regions. This study highlights the importance of having a scale-up plan from the outset, as well as the necessary knowledge and expertise, for successful scale-up.
Evidence of the health, environmental, and broader societal impacts of ultra-processed foods (UPFs) is rapidly accumulating, yet public awareness remains limited. This study aimed to develop a communication and messaging framework to increase public awareness of UPFs in Australia. The objectives were to: (1) develop recommendations to guide public health organisations in UPF communication strategies; and (2) develop persuasive messages to increase public awareness of UPFs. A theoretically informed, sequential mixed‑methods approach, informed by co-design principles, was used. It included: (1) Content extraction from dietary guidelines and messages development, informed by an Australian survey; (2) Literature review and messages refinement with consumers; (3) Interviews with Australian public health nutrition experts for feedback on the guide and messages; (4) Quantitative survey with UPF experts for content validity of messages; (5) Quantitative survey with Australian adults for face validity of messages; and (6) Consolidation of the communication and messaging framework. Twenty-seven excerpts were extracted from dietary guidelines of six countries and transformed into messages, with an additional 28 messages developed by the team. Messages were organised into the domains: UPF definition and identification; dietary; health; environmental; other impacts; and key dietary recommendations. Review findings informed messages refinement and the communication guide. A consumer panel reduced the set to 32 messages. Eleven Australian public health nutrition experts endorsed the framework and contributed refinements to improve clarity and relevance for Australia. Nineteen Australian and international UPF experts rated the 32 messages highly for importance (mean 6.4/7) and clarity (6.0/7), leading to the removal of one redundant message. The remaining messages were tested with 1,014 Australian adults, who reported high levels of understanding, likeability, and persuasiveness. The final set comprised 26 validated persuasive messages. The guide included: (1) communication goal; (2) audience segmentation; (3) message channels; (4) message design and tailoring; (5) delivery; and (6) outcome evaluation. This study presents a novel, evidence-based framework to raise public awareness of UPFs in Australia, developed in consultation with the public, UPF experts and public health organisations using co-design principles. It provides practical guidance to support nutrition communication and strategies to reduce UPF consumption.
Investigating food purchase data is a novel and effective approach to large-scale dietary assessment, but many traditional analysis methods often overlook the temporal structure of food purchases. This study demonstrates a data-driven approach for identifying and describing changes in food purchasing behaviors over time, using Hidden Markov Modeling (HMM) to assess the underlying structure of individual-level time-series purchase data. The loyalty cardholders of the LoCard study provided access to purchase data from 9/2016 to 12/2018 and responded to a background questionnaire providing cross-sectional information on sociodemographic characteristics and self-estimated share of purchases from the retailer (purchase loyalty) (n = 29,245). Food group-level data of participants with ≥ 40
Physical activity, sedentary behaviour, and sleep are three behaviours which occupy the 24-h cycle and interact to influence a multitude of health outcomes. Different terms are currently used to describe these behaviours collectively (e.g., movement behaviours or physical behaviours). The lack of clear and consistent terminology makes it hard to compare, interpret, and build on research findings. As a first step towards developing consensus on what terminology to use for discussing the 24-h cycle of physical activity, sedentary behaviour, and sleep, we conducted a scoping review to identify the breadth of terminology used to describe this phenomenon. All searches occurred between September 18th – 20th 2024. We searched nine databases: Medline, EMBASE, CINAHL, PsycInfo, Web of Science, Scopus, ERIC, Education Source, and Compendex from inception to September 18th 2024. The Journal of Activity, Sedentary and Sleep Behaviors and the International Network of Time-Use Epidemiologists (INTUE) publication lists were manually searched on September 19th – 20th 2024. Peer-reviewed articles were included if they 1) were published in English, Spanish, Portuguese, French, Chinese, Korean, or Japanese; 2) focused on humans; and 3) describe physical activity, sedentary behaviour, and sleep in an integrated manner. We identified different terminologies used for collectively discussing physical activity, sedentary behaviour, and sleep across the 24-h cycle. Our search identified 10,749 articles of which 979 articles met our inclusion criteria. Across all articles, 199 different terms were used to describe physical activity, sedentary behaviour, and sleep collectively. The term movement behaviours was used in 673 articles, 24-h movement behaviours was used in 457 articles, physical behaviours was used in 58 articles, 24-h activity cycle was used in 36 articles, and time-use behaviours was used in 31 articles. The two most popular terms for describing the collective interaction of physical activity, sedentary behaviour, and sleep are movement behaviours and 24-h movement behaviours. However, there is not yet an internationally recognized and agreed-upon term for holistically describing the 24-h cycle of physical activity, sedentary behaviour, and sleep. Developing a homogeneous and widely accepted set of terminology and definitions is thus critical if we hope to ensure clarity, enhance reproducibility, and enable the translation of future research into coherent guidelines, policies, and practices for these behaviours.
Previous studies have shown that physical activity (PA) benefits self-regulation (SR) in preschoolers. However, few studies have examined the effects of PA parameters such as intensity, duration, and delivery modality on domains of SR such as emotional, behavioural and cognitive SR. This study aimed to synthesize evidence from randomized controlled trials (RCT) to evaluate the effects of PA-interventions on SR-domains, and to identify intervention parameters most effective for SR development in preschool-aged children. Systematic literature search was conducted from February through to November 2025 across Web of Science, PsycINFO, and ERIC databases. Eligible studies included RCTs involving PA-interventions with preschoolers aged 18 to 71.99 months that assessed SR-domains. Of 2,510 studies screened and 192 full-text articles reviewed, 25 RCTs met inclusion criteria and were included in the meta-analysis. 24 studies were school-based interventions, and one was home-based. Data extraction, risk of bias, and quality assessments were independently conducted by two reviewers using the Cochrane RoB-2 (RoB-2) tool and QualSyst. Overall, meta-analyses showed that PA-interventions produced a small to moderate improvement in SR (g = 0.549, p < 0.01), with positive significant effects for behavioural SR (g = 0.452, p < 0.01), cognitive SR (g = 0.428, p < 0.01), and multi-SR-domains (g = 1.039, p < 0.01). Emotional SR was not significantly impacted (g = 0.390, p = 0.148). Subgroup analyses showed that both low-intensity (g = 0.620, p < 0.001) and moderate-to-vigorous PA (g = 0.388, p < 0.01), and group-based PA-interventions (g = 0.502, p < 0.01) significantly improved SR, but individual PA-interventions showed non-significant effects (g = 0.218, p = 0.189). Publication bias was indicated by Egger’s regression (t = 3.892; p < 0.01) and 21 studies had “some concerns,” three were “high” risk, and one “low” risk indicated by RoB-2, while QualSyst rated 15 studies as “strong” and 10 as “good.” PA-interventions significantly enhance SR in preschoolers, particularly when more than one SR-domain was examined. There were moderate benefits for cognitive and behavioural SR but limited effectiveness for emotional SR. Both low-intensity PA and MVPA are effective, and group-based interventions may be more impactful than individual delivery.
The primary aim was to identify combinations including ≥ 3 behavior change techniques (BCTs) that are jointly used in behavioral interventions for women with/survivors of breast cancer, and result in a simultaneous improvement of physical activity, healthy nutrition behaviour, and healthy body weight maintenance. A meta-review integrated evidence from systematic, scoping, and pragmatic reviews. Ten databases were searched using ASReviews software and through manual searches, resulting in the inclusion of 32 reviews. The ROBIS tool was applied to assess bias risk. All combinations of ≥ 3 BCTs were identified in the original studies, and ratios of studies indicating a significant improvement to those with no improvement were calculated for three outcome domains. BCT combinations used in ≥ 10 original intervention studies (with ≥ 3 studies per each outcome domain) and supported in ≥ 85
Food outlet practices that support consumers in making healthier food and drink purchases (e.g. healthy product availability and promotion) are key strategies for improving population diets. To have lasting population health impacts, these practices must be sustained. This study explored the perspectives of foodservice operators (e.g. food outlet owners, managers and staff) and practitioners who support them (e.g. health promotion officers and dietitians) on: (i) which healthy food retail practices are typically sustained or discontinued in foodservice contexts; (ii) key determinants influencing sustainment; (iii) support needs for sustaining change; and (iv) differences between sustainers and discontinuers. A national cross-sectional online survey was conducted with foodservice operators and implementation support practitioners. The survey was co-designed with representatives from Australian government health departments and health promotion agencies responsible for healthy food retail policies and/or implementation support. Recruitment targeted food retail in public settings (e.g. healthcare food retail, school canteens) and private outlets via Qualtrics panels, professional networks and social media. Survey questions were informed by the Integrated Sustainability Framework, the sustainment-explicit Expert Recommendations for Implementing Change glossary, and existing evidence in the foodservice context. The survey assessed sustained and discontinued practices, determinants of sustainment, and sustainment support needs. Participants were asked to rank selected determinants and support options to indicate relative importance. Descriptive analyses and exploratory chi-square tests were used. Of 327 eligible participants (234 foodservice operators, 93 practitioners), 212 reported having experience (sustainment or discontinuation) with healthy food retail practices. Among these, 74
Inadequate physical activity (PA) elevates chronic disease risk in low-income urban populations. Neighborhood parks may offer venues for PA, but effects likely depend on park quality and use patterns. This study examined whether citywide park renovations were associated with changes in adult PA and sedentary behavior (SB) in low-income New York City neighborhoods and whether associations between park use and PA/SB changes differed for residents near renovated vs. control parks. We conducted a quasi‑experimental prospective cohort study (2016–2022) in neighborhoods surrounding 31 renovated and 21 matched control parks. Participants included 344 adults living ≤ 0.3 miles of a study park (186 intervention, 158 control). Outcomes were accelerometry‑based PA/SB measures collected pre‑ and post‑renovation: vector magnitude per minute (VMPM) and minutes/day of sedentary time, light PA, and moderate‑to‑vigorous PA. Surveys assessed self‑reported typical frequency and duration of park visits. Linear mixed‑effects difference-in-differences models estimated associations between renovations and PA/SB changes; interaction models examined associations of park use with PA/SB changes in intervention vs. control groups. Changes in PA/SB were not significantly different between intervention and control groups. However, intervention participants who reported visiting their study park ≥ 30 min on a weekend day experienced a 140.0-unit/day greater increase in VMPM (95
School day physical activity (PA) is important for children’s health and development, yet longitudinal evidence on within-year trajectory patterns is limited. Traditional approaches to studying PA change may obscure substantial heterogeneity in how individual children’s PA evolves over time. We used person-centered latent analyses and cut-point-free accelerometer metrics to identify distinct school day PA profiles and examine how profile membership changed across one school year. Participants were 249 children aged 8–9 years from seven primary schools in northwest England. Wrist-worn accelerometers assessed school day PA at three timepoints during the 2023-24 school year (Autumn, Winter/Spring, Summer) using average acceleration (PA volume) and intensity gradient (PA intensity distribution) as population-independent metrics. Multiple imputation handled missing accelerometer data. Latent profile analysis was performed at each timepoint with latent transition analysis used to examine stability and change in profile membership across consecutive timepoints. Three distinct PA profiles were consistently identified across all timepoints: High PA (high volume, high intensity; 10.8–41.4
Health behaviours such as physical activity, sedentary behaviour, nutrition, sleep, alcohol consumption, and smoking are modifiable determinants of life satisfaction – an essential outcome for healthy ageing and well-being. We explored the longitudinal association between these health behaviours and life satisfaction among older adults in Canada. The study was a secondary analysis of data from the Canadian Longitudinal Study on Aging, focusing on 11,215 adults aged 65 years and older at baseline, with follow-ups 1 and 2 at three-year intervals. Data were analysed using linear mixed-effects growth curve models, stratified by gender, with health behaviours decomposed into within- and between-person components. At baseline, the participants’ mean (SD) age was 72.94 (5.64) years, and 54.2
Depression is associated with reduced physical activity (PA), and evidence on the long-term effects of interventions and their potential moderators remains limited. Thus, this study aimed to evaluate the short- (post-intervention) and long-term (six-month follow-up) effects of a PA-promoting intervention on contextual PA and to explore potential moderators in adults with depressive symptoms. A randomized, controlled, and assessor-blinded clinical trial was conducted with adults presenting depressive symptoms. The intervention lasted 16 weeks, with two sessions per week. Strategies were grounded in Self-Determination Theory and aimed to increase participants’ awareness of their lifestyle, primarily focusing on PA and its relationship with depression. Activities included lectures, group discussions, interactive activities with family and friends, and PA practices in different contexts. Intensity-specific PA was assessed using wrist-worn accelerometers, and contextual PA (by type and domain) was self-reported. Generalized estimating equations were used to assess intervention effects. Potential moderators (sex and age) were examined in exploratory analyses using three-way interaction terms. A total of 78 individuals (76.9
Meeting the 24-Hour Movement Guidelines (24-HMG), comprising aerobic physical activity, sedentary behavior including recreational screen time, and sleep, is critical for post-secondary student health. However, multi-year temporal trends spanning the pandemic and post-pandemic period, as well as sociodemographic and mental health disparities, remain understudied in Canada. This limits the development of targeted interventions. We conducted a serial cross-sectional analysis using Canadian Campus Wellbeing Survey data collected between 2019 and 2025. A self-reported questionnaire was administered annually to assess aerobic physical activity, sedentary behavior (including recreational screen time), sleep duration, sociodemographic characteristics, and mental health. Prevalence of meeting individual and integrated 24-HMG components was estimated. Temporal trends were examined using regression models with survey year treated as a continuous variable and were further stratified by sociodemographic characteristics and mental health status. Multivariable logistic regression was used to examine factors associated with meeting all guidelines and meeting none. Among 116,597 students (mean [SD] age, 23.95[8.02] years; 78,623[67.43
Prolonged sitting is strongly associated with impaired cognitive function. Although traditional exercise interventions have been shown to improve cognitive outcomes, their implementation is often limited by practical constraints. In contrast, introducing interruptions to prolonged sitting with brief bouts of standing or physical activity has emerged as a more feasible alternative. However, previous research has been dominated by qualitative reviews. Moreover, some quantitative studies have not adequately addressed effect-size dependency arising from multiple outcomes and time points within the same study, and quantitative evidence regarding specific cognitive domains and interruption-protocol parameters remains limited. Following the PRISMA guidelines, this study systematically searched PubMed, Web of Science, the Cochrane Library, Embase, and Scopus for randomized crossover trials published up to January 2026 that examined the effects of brief standing or physical activity breaks during prolonged sitting on cognitive function. A three-level random-effects meta-analysis was conducted to pool effect sizes, with cluster-robust variance estimation used to account for effect-size dependency resulting from multiple outcomes and time points within the same study. In addition, subgroup and meta-regression analyses were performed to investigate potential moderating factors. Risk of bias was assessed using the Risk of Bias 2 tool, and the certainty of the evidence was evaluated according to the GRADE framework. A total of 21 randomized crossover trials involving 433 participants were included. Compared with prolonged sitting, sitting interruptions involving standing or physical activity were associated with improvements in executive function (k = 16 studies; Hedges’ g = 0.18; 95
(Un)healthy eating behaviours may vary by moment and psychological context. Ecological momentary assessment (EMA) is well-suited to study within-person, momentary, and context-dependent behaviours and correlates, as it uses repeated sampling of real-time experiences. Insights in such within-person relations could inform ecological momentary interventions. A systematic review and meta-analysis of these insights in a healthy population is, however, currently lacking. The aim of this systematic review and meta-analysis was to synthesise within-person associations between psychological factors and eating behaviour in healthy adults, and summarise methodological aspects of these studies. Observational and experimental studies on psychological predictors of (un)healthy eating behaviours in adult healthy populations were included, based on a systematic search of Ovid MEDLINE, Embase, PsycINFO and Web of Science. Meta-analysis of ≥ 5 studies per predictor/outcome was performed in metafor R-package. During title and abstract screening, n = 2046 articles were reviewed (n = 119 from overarching review, n = 1927 from updated search), n = 208 were screened in full-text screening. Forty-nine (review) and fifteen studies (meta-analysis) were included. Most studies were observational, and used fixed time-based sampling, and most assessed food eaten since the last prompt/timeframe. Various measures reported on study adherence (between 79 and 90
Wearable accelerometers are widely used in health research, but differing placements (e.g. wrist vs. thigh) hinder harmonising activity classification across studies. Prior studies report 1.5- to 2.0-fold differences in physical activity level by wear location, hampering data comparability, and compromising the potential for pooling data to develop consortia and carrying out Meta- and Individual Participant Data analysis. Although supervised machine learning is increasingly used in wearables research, its reliance on extensive labelled data limits its use in free-living datasets. Semi-supervised learning offers an efficient alternative by using laboratory collected labelled data to iteratively self-train models on unlabelled free-living data. Using a self-training approach, the aim of this study was to train and evaluate algorithms for wrist- and thigh-worn devices to facilitate harmonisation of posture and activity type classification between placements. A total of 146 participants aged 30–75 years completed either structured laboratory-based activity trials or one of two independent free-living assessments while wearing Axivity AX3 accelerometers on the wrist and thigh. For each placement, a supervised Random Forest classifier was initially trained using a labelled laboratory dataset (n = 40) to classify sitting, standing, walking, running, stair climbing, and cycling - and then re-trained using self-training on free-living data (n = 53, independent to the laboratory study sample). The final models were validated using another hold-out free-living independent dataset (n = 53) with ground-truth activity labels obtained via direct video observation. Overall model comparison and performance was assessed using accuracy, kappa statistic, and F1 scores. Individual activity class comparison and performance was evaluated using equivalence testing, confusion matrices, and coefficient of variation between the wrist and thigh estimates. During a total of 43,800 min, of which 19,080 min were in the hold-out dataset, both self-trained models achieved high overall classification accuracy: 91.8
An unhealthy diet, excessive screen time, low levels of physical activity and suboptimal sleep are known risk factors for childhood overweight and obesity (OW/OB). These energy balance–related behaviors tend to co-occur and combine into “lifestyle patterns” (LPs) that may have a synergistic effect on OW/OB. However, few studies have examined these LPs before preschool age, and none investigated the possible involvement of parental feeding practices (e.g., breastfeeding and timing of complementary feeding), non-screen leisure activities and sleep quality. We aimed to identify such LPs during the first 2 years of life and assess their associations with OW/OB at age 5 years and age at adiposity rebound (AR). Participants were children from the French nationwide ELFE (Etude Longitudinale Française depuis l’Enfance) birth cohort. We used principal component analysis of 18 items characterizing parental feeding practices and children’s energy balance-related behaviors (n = 13,121) to derive LPs. We analyzed the associations of LPs with OW/OB at age 5 years (International Obesity Task Force definition; n = 8,388) and age at AR (in days; n = 7,845) using multivariable logistic and linear regression models, respectively. We identified three LPs: “Early complementary feeding, discretionary consumption, high screen time”, “Balanced diet, non-screen leisure activities”, and “Healthy feeding practices, low dairy consumption, suboptimal sleep” patterns. The first pattern was positively associated with OW/OB at age 5 years (OR [95
Mobility is a cornerstone of healthy ageing typically assessed using self-report and performance-based measures. Recent research suggests these measures are poor proxies for real-world mobility. Device-derived measures of real-world mobility reflect the relative proportions of time a person allocates to sedentary behaviour (SB), light-intensity physical activity (LIPA), and moderate-to-vigorous physical activity (MVPA) that together form the waking-day movement behaviour composition. The aim of this study was to examine the associations between commonly used mobility measures and the waking-day movement behaviour composition in older adults. A cross-sectional analysis of data from over 1200 older adults ≥ 65 years of age from the baseline cohort (2022–2024) of the McMaster Monitoring My Mobility (MacM3) study was conducted. Compositional data analysis was used to examine the associations between 6 self-report and 10 performance-based measures of mobility and multiple components of the waking-day movement behaviour composition and establish differences in movement behaviours according to different levels of mobility. Examples of included measures are the Physical Activity Scale for the Elderly (PASE) and Timed Up and Go (TUG). Data from 1227 older adults (73.6 ± 5.3 years) were analysed. Significant differences in waking-day movement behaviour composition were found across the self-report and performance-based mobility measures. Older adults with lower mobility accumulated more SB and less MVPA throughout the day. For example, those with poorer TUG performance accumulated 34 more minutes/day of SB, and 22 min/day less of MVPA compared to those with better performance. The PASE, 400-meter walk, and fast gait speed tests were the strongest indicators of real-world mobility; however, the effect sizes were small. No measure showed a significant association with LIPA. Traditional self-report and performance-based measures of mobility are associated with the waking-day movement behaviour composition in older adults; however, their ability to explain real-world mobility is limited and varies across measures. The lack of association between any of the measures and LIPA is surprising, given that older adults spend most of their time in this activity intensity. These findings challenge the widespread use of traditional mobility measures to make inferences about real-world mobility.
