The transition to higher education involves a significant life change and might be accompanied with less healthy behaviours. However, the only longitudinal study that spanned the period from high school to college/university was limited to self-reported weight. Other studies assessed objective weight, but only at the start of the first semester at college/university and used retrospective questionnaires to asses health behaviours in high school. This study investigated changes in objectively assessed weight and prospective health behaviours during the transition from high school to college/university in Belgian students and examined which health behaviour changes were related to weight change. A sample of 291 students was followed from the final year of high school until the second year of college/university. Body mass index (BMI) and waist circumference were measured objectively. Physical activity, sedentary behaviours and dietary intake were estimated using validated questionnaires. In order to study changes in BMI and health behaviours, 2 × 2 (time × gender) Repeated Measures ANOVA analyses were conducted. A stepwise multiple regression analysis was executed to investigate the association between changes in health behaviours and BMI changes, and the moderating effect of gender. On average students gained 2.7 kg with a greater increase in boys (boys: 4.2 kg, girls: 1.9 kg). Active transportation and sport participation decreased. Some sedentary behaviours (watching TV/DVD, playing computer games) decreased, while others (internet use, studying) increased. Consumption of different foods decreased, while alcohol consumption increased. A higher decrease in sport participation, a higher increase in internet use and a lower increase in studying were related to a greater increase in BMI. An increase in alcohol consumption only contributed to weight gain in boys, whereas a decrease in fruit/vegetable intake only contributed to weight gain in girls. We can conclude that the transition to higher education is an at risk period for weight gain and unfavourable changes in health behaviours. Interventions to prevent weight gain in college/university students should therefore already start in high school with a somewhat different focus in boys versus girls.

Adequate knowledge on environmental correlates of physical activity (PA) in older adults is needed to develop effective health promotion initiatives. However, research in this age group is scarce and most existing studies were conducted in North America. The present study aimed to examine relationships between GIS-based neighborhood walkability and objective and self-reported PA in community-dwelling Belgian older adults. Furthermore, moderating effects of neighborhood income levels were investigated. The Belgian Environmental Physical Activity Study (BEPAS) for Seniors is a cross-sectional study in older adults (≥65 yrs) and was conducted between October 2010 and September 2012. Data from 438 older adults living in 20 neighborhoods across Ghent (Belgium) were analyzed. Stratification of selected neighborhoods was based upon objective walkability and neighborhood income. Participants wore an accelerometer during seven consecutive days to obtain objective levels of moderate-to-vigorous physical activity (MVPA). Self-reported levels of transportation walking/cycling and recreational walking/cycling were assessed using the International Physical Activity Questionnaire (long, last 7 days version) adapted for the elderly. Multi-level regression analyses were conducted. Findings showed a positive relationship between neighborhood walkability and weekly minutes of older adults’ self-reported walking for transportation (B = 4.63 ± 1.05;p < 0.001) and a negative relationship between walkability and accelerometer-derived low-light PA (B = −1.38 ± 0.62;p = 0.025). Walkability was not related to any measure of recreational PA. A walkability x income interaction was found for accelerometer-derived MVPA (B = -1.826 ± 1.03;p = 0.075), showing only a positive association between walkability and MVPA in low-income neighborhood residents. This was the first European study to examine walkability-PA relationships in older adults. These Belgian findings suggest that a high neighborhood walkability relates to higher levels of older adults’ transport-related walking. As transport-related walking is an accessible activity for older adults and easy to integrate in their daily routine, policy makers and health promoters are advised to provide sufficient destinations and pedestrian-friendly facilities in the close vicinity of older adults’ residences, so short trips can be made by foot. Neighborhood income moderated the relationship between walkability and objectively-measured MVPA. Increasing total MVPA levels in older adults should be a key topic in development of promotion initiatives and special attention should be paid to low-income neighborhood residents.

Background: Physical activity (PA) has been consistently implicated in the etiology of obesity, whereas recent evidence on the importance of sedentary time remains inconsistent. Understanding of dose–response associations of PA and sedentary time with overweight and obesity in adults can be improved with large-scale studies using objective measures of PA and sedentary time. The purpose of this study was to examine the strength, direction and shape of dose–response associations of accelerometer-based PA and sedentary time with body mass index (BMI) and weight status in 10 countries, and the moderating effects of study site and gender. Methods: Data from the International Physical activity and the Environment Network (IPEN) Adult study were used. IPEN Adult is an observational multi-country cross-sectional study, and 12 sites in 10 countries are included. Participants wore an accelerometer for seven consecutive days, completed a socio-demographic questionnaire and reported height and weight. In total, 5712 adults (18–65 years) were included in the analyses. Generalized additive mixed models, conducted in R, were used to estimate the strength and shape of the associations. Results: A curvilinear relationship of accelerometer-based moderate-to-vigorous PA and total counts per minute with BMI and the probability of being overweight/obese was identified. The associations were negative, but weakened at higher levels of moderate-to-vigorous PA (>50 min per day) and higher counts per minute. No associations between sedentary time and weight outcomes were found. Complex site- and gender-specific findings were revealed for BMI, but not for weight status. Conclusions: On the basis of these results, the current Institute of Medicine recommendation of 60 min per day of moderate-to-vigorous PA to prevent weight gain in normal-weight adults was supported. No relationship between sedentary time and the weight outcomes was present, calling for further examination. If moderator findings are confirmed, the relationship between PA and BMI may be country- and gender-dependent, which could have important implications for country-specific health guidelines.

Background: Streetscape (microscale) features of the built environment can influence people’s perceptions of their neighborhoods’ suitability for physical activity. Many microscale audit tools have been developed, but few have published systematic scoring methods. We present the development, scoring, and reliability of the Microscale Audit of Pedestrian Streetscapes (MAPS) tool and its theoretically-based subscales. Methods: MAPS was based on prior instruments and was developed to assess details of streetscapes considered relevant for physical activity. MAPS sections (route, segments, crossings, and cul-de-sacs) were scored by two independent raters for reliability analyses. There were 290 route pairs, 516 segment pairs, 319 crossing pairs, and 53 cul-de-sac pairs in the reliability sample. Individual inter-rater item reliability analyses were computed using Kappa, intra-class correlation coefficient (ICC), and percent agreement. A conceptual framework for subscale creation was developed using theory, expert consensus, and policy relevance. Items were grouped into subscales, and subscales were analyzed for inter-rater reliability at tiered levels of aggregation. Results: There were 160 items included in the subscales (out of 201 items total). Of those included in the subscales, 80 items (50.0%) had good/excellent reliability, 41 items (25.6%) had moderate reliability, and 18 items (11.3%) had low reliability, with limited variability in the remaining 21 items (13.1%). Seventeen of the 20 route section subscales, valence (positive/negative) scores, and overall scores (85.0%) demonstrated good/excellent reliability and 3 demonstrated moderate reliability. Of the 16 segment subscales, valence scores, and overall scores, 12 (75.0%) demonstrated good/excellent reliability, three demonstrated moderate reliability, and one demonstrated poor reliability. Of the 8 crossing subscales, valence scores, and overall scores, 6 (75.0%) demonstrated good/excellent reliability, and 2 demonstrated moderate reliability. The cul-de-sac subscale demonstrated good/excellent reliability. Conclusions: MAPS items and subscales predominantly demonstrated moderate to excellent reliability. The subscales and scoring system represent a theoretically based framework for using these complex microscale data and may be applicable to other similar instruments.

Background: From a health perspective it is suggested to promote a positive balance between time spent in light intensity physical activity (LIPA) and sedentary behaviour (SB) (i.e. spending more time in LIPA than time spent in SB). However, no studies have reported prevalence rates of the LIPA-SB balance yet. The aim of this study was to objectively investigate the time spent in SB, in LIPA and moderate-to-vigorous intensity physical activity (MVPA) in four Belgian age groups and to explore which proportion of the population had a favorable balance between LIPA and SB and combined this with recommended amount of MVPA. Methods: Accelerometer data from 7 cross-sectional studies (N=2083) in four age groups (preschoolers, primary schoolchildren, secondary schoolchildren and adults) were aggregated. Differences in SB and PA between age groups and between men and women were determined by two-way MANCOVA. LIPA-SB balance was calculated and participants were categorized into one of four groups: (1) positive LIPA-SB balance (LIPA> SB) & sufficient MVPA (2) negative LIPA-SB balance & sufficient MVPA (3) positive LIPA-SB balance & insufficient MVPA (4) negative LIPA-SB balance & insufficient MVPA. Results: For the total sample, 55% of the waking time was spent in SB, 39% in LIPA and 6% in MVPA. Differences in SB between age groups was dependent from gender (p<0.001). Further, a positive LIPA-SB balance was assessed in 18% of the total sample and only 10% combined this positive balance with recommended amount of MVPA. Secondary schoolgirls were most at risk, with only 1% of the sample combining a positive LIPA-SB balance with sufficient MVPA. Another risk group was the large proportion (43%) of adult men who combined sufficient MVPA with a negative LIPA-SB balance. Conclusion: A high proportion of the Belgian population is at risk if taking into account both SB and PA levels. Secondary schoolgirls have the unhealthiest SB and PA profile and are therefore an important target group for interventions both increasing MVPA and decreasing SB. In men more attention should be given in promoting a positive LIPA-SB balance independently from their compliance with the MVPA guidelines.