Emily Mire - Academia.edu (original) (raw)

Papers by Emily Mire

Table S1. Associations of breakfast frequency defined using two categories with physical activity... more Table S1. Associations of breakfast frequency defined using two categories with physical activity and sedentary time in children from 12 countries.â Table showing associations of breakfast frequency defined using two categories with physical activity and sedentary time in children from 12 countries. (DOC 121 kb)

media use, and other sedentary activities. Children’s sleep durations were also reported by their... more media use, and other sedentary activities. Children’s sleep durations were also reported by their parents. A hierarchical cluster analysis using Ward’s method with squared Euclidean distance was performed to determine the potential number of clusters in boys and girls, respectively. The analyses of covariance were conducted to compare the minutes in PA, SB and sleep across the clusters, controlling for age. RESULTS: Five clusters emerged as tenable for both boys and girls to explain the grouping of SB, PA and sleep duration. For boys, the five clusters were labelled as ‘multi-modal SB/high PA/inadequate sleep’ (20%), ‘sedentary homeworkers/some PA/inadequate sleep’ (25%), ‘semi-sedentary/high PA/inadequate sleep’ (16%), ‘low SB/low PA/short sleep’ (11%), and ‘low SB/low PA/reasonable sleep’ (28%). No differences were found in overweight prevalence across the five clusters. A higher proportion of girls (36%) were labelled as ‘low SB/some PA/short sleep’ (36%). The other four clusters...

Current Developments in Nutrition, 2021

Objectives Persons with food insecurity (FI) have been shown to have lower fruit and vegetable (F... more Objectives Persons with food insecurity (FI) have been shown to have lower fruit and vegetable (F/V) intake and higher fat intake compared to individuals with food security (FS). However, currently there are limited data as to whether diet can be improved during weight loss interventions in persons with FI. Methods Patients with obesity (BMI 30 - 50 kg/m2) were recruited into the Promoting Successful Weight Loss in Primary Care in Louisiana (PROPEL) trial, which randomized 18 clinics to either an intensive lifestyle intervention (ILI) or usual care (UC). At baseline, FI was determined by the 6-Item Food Security Survey. At baseline and Month (M) 6, 12, and 24, F/V intake was determined by a brief screener and fat intake was determined by the % Energy from Fat Screener. The outcomes were analyzed by repeated-measures linear mixed-effects multilevel models, which included random cluster (clinic) effects and were stratified by FI. In addition to group, time, and their interaction, the ...

Obesity (Silver Spring, Md.), Jun 1, 2017

To examine the joint association of birth weight and physical activity/sedentary time with childh... more To examine the joint association of birth weight and physical activity/sedentary time with childhood obesity in 12 countries. A cross-sectional study of 5,088 children aged 9 to 11 years was conducted. Birth weight was recalled by parents or guardians. Moderate-to-vigorous physical activity (MVPA) and sedentary behavior were objectively measured using accelerometry. The association of birth weight with the odds of obesity, central obesity, and high body fat was significant among children with either low MVPA or high sedentary time but not among children with either high MVPA or low sedentary time. In comparison with children with normal birth weight and high MVPA, children with high birth weight and low MVPA showed 4.48- to 5.18-fold higher odds of obesity, central obesity, and high body fat; children with normal birth weight and low MVPA showed 3.00- to 3.30-fold higher odds of obesity, central obesity, and high body fat, and children with high birth weight and high MVPA showed 1.1...

Background: Abnormal body compositions such as high adiposity (HA), low muscle mass (LM), or a co... more Background: Abnormal body compositions such as high adiposity (HA), low muscle mass (LM), or a combination of the 2 [high adiposity with low muscle mass (HA-LM)] are relevant phenotypes, but data on their prevalence and impact on health are still limited. This is largely because of a lack of a consensus definition for these conditions. Of particular interest is the HA-LM phenotype, also termed "sarcopenic obesity," which may confer greater health risk. Objective: We propose a new approach for operationalizing abnormal body-composition phenotypes in a representative adult population. Design: Whole-body dual-energy X-ray absorptiometry data obtained from the 1999-2004 NHANES were analyzed for 13,236 subjects aged $18 y (maximum weight and height of 136 kg and 1.96 m, respectively). Sex-and body mass index (BMI)-specific decile groups of appendicular skeletal muscle index (ASMI; kg/m 2) and fat mass index (FMI; kg/m 2) were developed. Cutoffs for HA and LM were incorporated into a diagnostic framework to characterize 4 specific body-composition phenotypes-low adiposity with high muscle mass, high adiposity with high muscle mass, low adiposity with low muscle mass, and HA-LM-and a subclassification of the phenotypes into classes I, II, and III. Results: Abnormal phenotypes were prevalent across the age spectrum and BMI categories. The association between ASMI or FMI and age was modified by sex and BMI. The prevalence of HA-LM in the whole sample was 10.3% in women and 15.2% in men. The prevalence of all subclasses of HA-LM in obese women and men was 14.7% and 22.9%, respectively. HA-LM class III was more prevalent in obese men (2.3%) than in obese women (0.3%). Conclusions: We developed sex-and BMI-specific reference curves to harmonize the classification of body-composition phenotypes. The application of this classification will be particularly useful in the identification of cases of sarcopenic obesity. The association of these phenotypes with metabolic deregulation and increased disease risk awaits verification.

The Journal of Pediatrics, 2015

Objective To provide sex-and-age specific normative values for children and adolescents' accelero... more Objective To provide sex-and-age specific normative values for children and adolescents' accelerometerdetermined steps/day, and peak 60-minute cadence adjusted to a pedometer-based scale. Study design The analysis sample was 2610 children and adolescents (1329 girls) from the 2005-2006 National Health and Nutrition Examination Survey. Accelerometer data were adjusted by eliminating steps counted when activity counts/min <500. Peak 60-minute cadence represented the 60 highest minutes of accumulated steps, averaged over monitored days. Normative data included quintile-defined categories of adjusted steps/day and peak 60-minute cadence for 7 age groups (6-7, 8-9, 10-11, 12-13, 14-15, 16-17, and 18-19 years). LMSChartmakerPro produced 10 age-group-specific smoothed curves (5 for each sex) showing the 5th, 25th, 50th, 75th, and 95th percentiles, respectively, for steps/day and peak 60-minute cadence. Results Steps/day was inversely associated with age in both boys and girls. The age-associated reduction was apparent in only small decrements for boys; the girl's reduction was steeper. Boys appeared to maintain or increase their peak 60-minute cadence with increased age between 8 and 15 years of age, with a reduction apparent over the last 2 age groups investigated. The peak 60-minute cadence was more variable for girls; a similar sharp reduction (3-6 steps/min) in tandem with the steps/day was apparent between 10-to 11-year-old girls and 12-to 13-year-old girls. Conclusions We provided detailed information and normative data pertaining to steps/d and peak 60-minute cadence in US children and adolescents. Like well-known body mass index growth curves, these data may be useful for scientists and clinical practitioners.

Public health nutrition, Jan 15, 2014

Fat mass (FM) and fat-free mass (FFM) are frequently measured to define body composition phenotyp... more Fat mass (FM) and fat-free mass (FFM) are frequently measured to define body composition phenotypes. The load-capacity model integrates the effects of both FM and FFM to improve disease-risk prediction. We aimed to derive age-, gender- and BMI-specific reference curves of load-capacity model indices in an adult population (≥18 years). Cross-sectional study. Dual-energy X-ray absorptiometry was used to measure FM, FFM, appendicular skeletal muscle mass (ASM) and truncal fat mass (TrFM). Two metabolic load-capacity indices were calculated: ratio of FM (kg) to FFM (kg) and ratio of TrFM (kg) to ASM (kg). Age-standardised reference curves, stratified by gender and BMI (<25·0 kg/m2, 25·0-29·9 kg/m2, ≥30·0 kg/m2), were constructed using an LMS approach. Percentiles of the reference curves were 5th, 15th, 25th, 50th, 75th, 85th and 95th. Secondary analysis of data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). The population included 6580 females and 6656 ...

PLoS ONE, 2014

Aims: Recent literature has posed sedentary behaviour as an independent entity to physical inacti... more Aims: Recent literature has posed sedentary behaviour as an independent entity to physical inactivity. This study investigated whether associations between sedentary behaviour and cardio-metabolic biomarkers remain when analyses are adjusted for total physical activity. Methods: Cross-sectional analyses were undertaken on 4,618 adults from the 2003/04 and 2005/06 U.S. National Health and Nutrition Examination Survey. Minutes of sedentary behaviour and moderate-to-vigorous physical activity (MVPA), and total physical activity (total daily accelerometer counts minus counts accrued during sedentary minutes) were determined from accelerometry. Associations between sedentary behaviour and cardio-metabolic biomarkers were examined using linear regression. Results: Results showed that sedentary behaviour was detrimentally associated with 8/11 cardio-metabolic biomarkers when adjusted for MVPA. However, when adjusted for total physical activity, the associations effectively disappeared, except for C-reactive protein, which showed a very small, favourable association (b = 20.06) and triglycerides, which showed a very small, detrimental association (b = 0.04). Standardised betas suggested that total physical activity was consistently, favourably associated with cardio-metabolic biomarkers (9/11 biomarkers, standardized b = 0.08-0.30) while sedentary behaviour was detrimentally associated with just 1 biomarker (standardized b = 0.12). Conclusion: There is virtually no association between sedentary behaviour and cardio-metabolic biomarkers once analyses are adjusted for total physical activity. This suggests that sedentary behaviour may not have health effects independent of physical activity.

Obesity, 2013

Objective-To examine the combined influence of moderate-to-vigorous physical activity (MVPA) and ... more Objective-To examine the combined influence of moderate-to-vigorous physical activity (MVPA) and sedentary behavior on obesity in US adults. Design and Methods-Cross-sectional analyses were undertaken on a nationally representative sample of 5,083 adults from the April 2003 and June 2005 National Health and Nutrition Examination Survey. Self-reported TV time was divided into low, moderate, and high categories. Accelerometer-derived total sedentary and MVPA minutes divided into low, moderate, and high tertiles. The independent associations between MVPA, TV, and total sedentary time and obesity were examined using logistic regression. Participants were then cross tabulated into nine MVPAsedentary behavior groups, and logistic regression was used to examine the combined influence of MVPA and sedentary behavior on the odds of being obese. Results-MVPA was consistently inversely associated with obesity, regardless of sedentary behavior [odds ratio (OR) = 1.80-4.00]. There were inconsistent positive associations between TV time and risk of obesity in men, but not between total sedentary time and risk of obesity in either men or women. Conclusions-Obesity was more strongly related to MVPA than either TV time or total sedentary time in US adults. Small differences in daily MVPA (5-10 min) were associated with relatively large differences in risk of obesity.

New England Journal of Medicine

BACKGROUND Evidence of the effectiveness of treatment for obesity delivered in primary care setti... more BACKGROUND Evidence of the effectiveness of treatment for obesity delivered in primary care settings in underserved populations is lacking. METHODS We conducted a cluster-randomized trial to test the effectiveness of a high-intensity, lifestyle-based program for obesity treatment delivered in primary care clinics in which a high percentage of the patients were from low-income populations. We randomly assigned 18 clinics to provide patients with either an intensive lifestyle intervention, which focused on reduced caloric intake and increased physical activity, or usual care. Patients in the intensive-lifestyle group participated in a highintensity program delivered by health coaches embedded in the clinics. The program consisted of weekly sessions for the first 6 months, followed by monthly sessions for the remaining 18 months. Patients in the usual-care group received standard care from their primary care team. The primary outcome was the percent change from baseline in body weight at 24 months. RESULTS All 18 clinics (9 assigned to the intensive program and 9 assigned to usual care) completed 24 months of participation; a median of 40.5 patients were enrolled at each clinic. A total of 803 adults with obesity were enrolled: 452 were assigned to the intensive-lifestyle group, and 351 were assigned to the usual-care group; 67.2% of the patients were Black, and 65.5% had an annual household income of less than $40,000. Of the enrolled patients, 83.4% completed the 24-month trial. The percent weight loss at 24 months was significantly greater in the intensive-lifestyle group (change in body weight, −4.99%; 95% confidence interval [CI], −6.02 to −3.96) than in the usual-care group (−0.48%; 95% CI, −1.57 to 0.61), with a mean between-group difference of −4.51 percentage points (95% CI, −5.93 to −3.10) (P<0.001). There were no significant between-group differences in serious adverse events. CONCLUSIONS A high-intensity, lifestyle-based treatment program for obesity delivered in an underserved primary care population resulted in clinically significant weight loss at 24 months. (Funded by the Patient-Centered Outcomes Research Institute and others; PROPEL ClinicalTrials.gov number, NCT02561221.

Circulation

Background: Intensive lifestyle interventions (ILIs) are the first-line approach to effectively t... more Background: Intensive lifestyle interventions (ILIs) are the first-line approach to effectively treat obesity and manage associated cardiometabolic risk factors. Because few people have access to ILIs in academic health centers, primary care must implement similar approaches for a meaningful effect on obesity and cardiometabolic disease prevalence. To date, however, effective lifestyle-based obesity treatment in primary care is limited. We examined the effectiveness of a pragmatic ILI for weight loss delivered in primary care among a racially diverse, low-income population with obesity for improving cardiometabolic risk factors over 24 months. Methods: The PROPEL trial (Promoting Successful Weight Loss in Primary Care in Louisiana) randomly allocated 18 clinics equally to usual care or an ILI and subsequently enrolled 803 (351 usual care, 452 ILI) adults (67% Black, 84% female) with obesity from participating clinics. The usual care group continued to receive their normal primary ca...

JAMA Network Open

IMPORTANCE Food insecurity is a pervasive public health issue in the US that is associated with g... more IMPORTANCE Food insecurity is a pervasive public health issue in the US that is associated with greater body weight.

Medicine & Science in Sports & Exercise

PLOS ONE

Background The coexistence of undernutrition (thinness) and overnutrition (overweight/obesity) am... more Background The coexistence of undernutrition (thinness) and overnutrition (overweight/obesity) among children and adolescents is a public health concern in low-middle-income countries. Accurate prevalence estimates of thinness and overweight/obesity among children and adolescents are unavailable in many low-middle-income countries due to lack of data. Here we describe the prevalences and examine correlates of objectively measured weight status among urban and rural schoolchildren in Mozambique.

Applied Physiology, Nutrition, and Metabolism

The purpose of this study was to test whether estimates of bedtime, wake time, and sleep period t... more The purpose of this study was to test whether estimates of bedtime, wake time, and sleep period time (SPT) were comparable between an automated algorithm (ALG) applied to waist-worn accelerometry data and a sleep log (LOG) in an adult sample. A total of 104 participants were asked to log evening bedtime and morning wake time and wear an ActiGraph wGT3X-BT accelerometer at their waist for 24 h/day for 7 consecutive days. Mean difference and mean absolute difference (MAD) were computed. Pearson correlations and dependent-sample t tests were used to compare LOG-based and ALG-based sleep variables. Effect sizes were calculated for variables with significant mean differences. A total of 84 participants provided 2+ days of valid accelerometer and LOG data for a total of 368 days. There was no mean difference (p = 0.47) between LOG 472 ± 59 min and ALG SPT 475 ± 66 min (MAD = 31 ± 23 min, r = 0.81). There was no significant mean difference between bedtime (2348 h and 2353 h for LOG and ALG...

American Journal of Human Biology

BMC Public Health

Background: Existing research has documented inconsistent findings for the associations among bre... more Background: Existing research has documented inconsistent findings for the associations among breakfast frequency, physical activity (PA), and sedentary time in children. The primary aim of this study was to examine the associations among breakfast frequency and objectively-measured PA and sedentary time in a sample of children from 12 countries representing a wide range of human development, economic development and inequality. The secondary aim was to examine interactions of these associations between study sites. Methods: This multinational, cross-sectional study included 6228 children aged 9-11 years from the 12 International Study of Childhood Obesity, Lifestyle and the Environment sites. Multilevel statistical models were used to examine associations between self-reported habitual breakfast frequency defined using three categories (breakfast consumed 0 to 2 days/week [rare], 3 to 5 days/week [occasional] or 6 to 7 days/week [frequent]) or two categories (breakfast consumed less than daily or daily) and accelerometry-derived PA and sedentary time during the morning (wake time to 1200 h) and afternoon (1200 h to bed time) with study site included as an interaction term. Model covariates included age, sex, highest parental education, body mass index z-score, and accelerometer waking wear time. Results: Participants averaged 60 (s.d. 25) min/day in moderate-to-vigorous PA (MVPA), 315 (s.d. 53) min/day in light PA and 513 (s.d. 69) min/day sedentary. Controlling for covariates, breakfast frequency was not significantly associated with total daily or afternoon PA and sedentary time. For the morning, frequent breakfast consumption was associated with a higher proportion of time in MVPA (0.3%), higher proportion of time in light PA (1.0%) and lower min/day and proportion of time sedentary (3.4 min/day and 1.3%) than rare breakfast consumption (all p ≤ 0.05). No significant associations were found when comparing occasional with rare or frequent breakfast consumption, or daily with less than daily breakfast consumption. Very few significant interactions with study site were found. Conclusions: In this multinational sample of children, frequent breakfast consumption was associated with higher MVPA and light PA time and lower sedentary time in the morning when compared with rare breakfast consumption, although the small magnitude of the associations may lack clinical relevance.

Journal of Aging and Physical Activity

Walking cadence (steps per minute) is associated with the intensity of ambulatory behavior. This ... more Walking cadence (steps per minute) is associated with the intensity of ambulatory behavior. This analysis provides normative values for peak 30-min cadence, an indicator of “natural best effort” during free-living behavior. A sample of 1,196 older adults (aged from 60 to 85+) with accelerometer data from the National Health and Nutrition Examination Survey 2005–2006 was used. Peak 30-min cadence was calculated for each individual. Quintile-defined values were computed, stratified by sex and age groups. Smoothed sex-specific centile curves across the age span were fitted using the LMS method. Peak 30-min cadence generally trended lower as age increased. The uppermost quintile value was >85 steps/min (men: 60–64 years), and the lowermost quintile value was <22 steps/min (women: 85+). The highest 95th centile value was 103 steps/min (men: 64–70 years), and the lowest 5th centile value was 15 steps/min (women: 85+). These normative values may be useful for evaluating older adults’...