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      Associations of Leisure-Time Internet and Computer Use With Overweight and Obesity, Physical Activity and Sedentary Behaviors: Cross-Sectional Study

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          Abstract

          Background

          Internet and computer use are increasingly common leisure-time sedentary behaviors, which have the potential to impact negatively on health outcomes. However, little is known about the extent to which adults’ Internet and computer use is associated with weight status and time spent in leisure-time physical activity.

          Objective

          The objective is to examine associations of leisure-time Internet and computer use with overweight and obesity, leisure-time physical activity, and other sedentary behaviors.

          Methods

          Participants (2650 adults living in Adelaide, Australia) completed a mail-back questionnaire including items on their height and weight, past seven day recall of leisure-time physical activity, Internet and computer use, and other leisure-time sedentary behaviors. Leisure-time Internet and computer use was categorized into no use, low use (less than three hours per week), or high use (three hours or more per week).

          Results

          Participants with low leisure-time Internet and computer use had the highest levels of educational attainment and employment, and engaged in less other sedentary behaviors when compared to participants with no or high Internet and computer use. Multinomial logistic regression, adjusted for gender, age, employment, education, other sedentary behaviors and physical activity, determined that participants with a high leisure-time Internet and computer use were 1.46 (95% CI = 1.10 - 1.93) times more likely to be overweight (BMI≥25 and < 30 kg/m 2) and 2.52 times more likely (95% CI = 1.82 - 3.52) to be obese (BMI≥30 kg/m 2), compared to those who reported no Internet and computer use in their leisure-time. Adults with high leisure-time Internet and computer use were more likely to be overweight or obese even if they were highly active in their leisure time (OR = 1.86; 95% CI = 1.21 - 2.88), as compared to participants who did not use the Internet or computer. Leisure-time physical activity levels were largely independent of Internet and computer use.

          Conclusion

          These findings suggest that, apart from nutritional and physical activity interventions, it may also be necessary to decrease time spent in sedentary behaviors, such as leisure-time Internet and computer use, in order to reduce the prevalence of overweight and obesity. Future Internet interventions to reduce weight or increase physical activity may need to differentiate between participants with different levels of Internet use in order to increase their effectiveness. Longitudinal studies are required to examine further the potential causal relationships between the development of overweight and specific sedentary behaviors such as Internet and computer use.

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          Most cited references26

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          Neighborhood walkability and the walking behavior of Australian adults.

          The physical attributes of residential neighborhoods, particularly the connectedness of streets and the proximity of destinations, can influence walking behaviors. To provide the evidence for public health advocacy on activity-friendly environments, large-scale studies in different countries are needed. Associations of neighborhood physical environments with adults' walking for transport and walking for recreation must be better understood. Walking for transport and walking for recreation were assessed with a validated survey among 2650 adults recruited from neighborhoods in an Australian city between July 2003 and June 2004, with neighborhoods selected to have either high or low walkability, based on objective measures of connectedness and proximity derived from geographic information systems (GIS) databases. The study design was stratified by area-level socioeconomic status, while analyses controlled for participant age, gender, individual-level socioeconomic status, and reasons for neighborhood self-selection. A strong independent positive association was found between weekly frequency of walking for transport and the objectively derived neighborhood walkability index. Preference for walkable neighborhoods moderated the relationship of walkability with weekly minutes, but not the frequency of walking for transport--walkability was related to higher frequency of transport walking, irrespective of neighborhood self-selection. There were no significant associations between environmental factors and walking for recreation. Associations of neighborhood walkability attributes with walking for transport were confirmed in Australia. They accounted for a modest but statistically significant proportion of the total variation of the relevant walking behavior. The physical environment attributes that make up the walkability index are potentially important candidate factors for future environmental and policy initiatives designed to increase physical activity.
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            Internet-Based Physical Activity Interventions: A Systematic Review of the Literature

            Background Nowadays people are extensively encouraged to become more physically active. The Internet has been brought forward as an effective tool to change physical activity behavior. However, little is known about the evidence regarding such Internet-based interventions. Objective The aim of the study was to systematically assess the methodological quality and the effectiveness of interventions designed to promote physical activity by means of the Internet as evaluated by randomized controlled trials. Methods A literature search was conducted up to July 2006 using the databases PubMed, Web of Science, EMBASE, PsycINFO, and Cochrane Library. Only randomized controlled trials describing the effectiveness of an Internet-based intervention, with the promotion of physical activity among adults being one of its major goals, were included. Data extracted included source and year of publication, country of origin, targeted health behaviors, participants’ characteristics, characteristics of the intervention, and effectiveness data. In addition, the methodological quality was assessed. Results The literature search resulted in 10 eligible studies of which five met at least nine out of 13 general methodological criteria. The majority of the interventions were tailored to the characteristics of the participants and used interactive self-monitoring and feedback tools. Six studies used one or more theoretical models to compose the contents of the interventions. One study used an objective measure to assess the amount of physical activity (activity monitor), and six studies used multiple subjective measures of physical activity. Furthermore, half of the studies employed measures of physical fitness other than physical activity. In three studies, an Internet-based physical activity intervention was compared with a waiting list group. Of these three studies, two reported a significantly greater improvement in physical activity levels in the Internet-based intervention than in the control group. Seven studies compared two types of Internet-based physical activity interventions in which the main difference was either the intensity of contact between the participants and supervisors (4 studies) or the type of treatment procedures applied (3 studies). In one of these studies, a significant effect in favor of an intervention with more supervisor contact was seen. Conclusions There is indicative evidence that Internet-based physical activity interventions are more effective than a waiting list strategy. The added value of specific components of Internet-based physical activity interventions such as increased supervisor contact, tailored information, or theoretical fidelity remains to be established. Methodological quality as well as the type of physical activity outcome measure varied, stressing the need for standardization of these measures.
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              Associations of TV viewing and physical activity with the metabolic syndrome in Australian adults.

              We analysed a sample of Australian adults to determine the strength of associations of TV viewing and participation in physical activity with the metabolic syndrome. This population-based cross-sectional study included 6,241 adults aged > or =35 years who were free from diagnosed diabetes mellitus and self-reported ischaemic disease and were not taking lipid-lowering or antihypertensive drugs. The metabolic syndrome was defined according to the 1999 World Health Organization criteria. Participants self-reported TV viewing time and physical activity time for the previous week. The adjusted odds ratio of having the metabolic syndrome was 2.07 (95% CI 1.49-2.88) in women and 1.48 (95% CI 0.95-2.31) in men who watched TV for >14 h per week compared with those who watched or =2.5 h per week). Longer TV viewing (>14 h per week) was associated with an increased risk of insulin resistance, obesity and dyslipidaemia in both men and women. A total physical activity time of > or =2.5 h per week was associated with a reduced prevalence of both insulin resistance and dyslipidaemia in both sexes and reduced prevalence of both obesity and hypertension in women. Increased TV viewing time was associated with an increased prevalence of the metabolic syndrome, while physical activity was associated with a reduced prevalence. Population strategies addressing the metabolic syndrome should focus on reducing sedentary behaviours such as TV viewing, as well as increasing physical activity.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                Gunther Eysenbach (Centre for Global eHealth Innovation, Toronto, Canada )
                1438-8871
                Jul-Sep 2009
                27 July 2009
                : 11
                : 3
                : e28
                Affiliations
                [2] 2simpleCancer Prevention Research Centre simpleUniversity of Queensland HerstonAustralia
                [1] 1simpleInstitute for Health and Social Sciences Research simpleCentral Queensland University RockhamptonAustralia
                Article
                v11i3e28
                10.2196/jmir.1084
                2762849
                19666455
                09bc10bc-73de-4c52-8468-fff15fb62328
                © Corneel Vandelanotte, Takemi Sugiyama, Paul Gardiner, Neville Owen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 27.07.2009.  

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 10 April 2008
                : 24 November 2008
                : 23 February 2009
                : 04 April 2009
                Categories
                Original Paper

                Medicine
                internet,computer,overweight,obese,bmi,body mass index,physical activity,human activities,sedentary behavior,leisure-time,leisure activities

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