Objective Anxious and depressive states are associated with increased cardiovascular disease (CVD) risk and a proinflammatory phenotype, although the latter appears to be at least partially explained by adiposity. We hypothesized that depression and anxiety would be associated with elevated inflammation independent of adiposity in persons with obesity at high risk of CVD. Methods We explored the relation between baseline anxiety as measured by the Beck Anxiety Inventory (BAI) and depression as measured by the Beck Depression Inventory-II (BDI-II), and baseline serum c-reactive protein (CRP) in a cross-sectional sample of 100 participants [mean (SD) age 57.8 (7.7) years; 64% female] with obesity [mean (SD) body mass index, BMI 37.3 (5.5) kg/m2] enrolled in a clinical trial for pharmacological weight loss interventions. Results BAI, but not BDI-II, scores were significantly correlated with CRP (rho=0.28, p=0.005). BMI was also highly correlated with CRP (rho=0.42, p<0.0001). In multivariate models, the relation between anxiety and CRP remained significant (p=0.038), independent of BMI, age and sex. Conclusion Anxiety, but not depression, is associated with elevated inflammation in persons with obesity beyond that attributable to higher BMI. Further study is warranted to assess whether anxiety represents a potential therapeutic target to mitigate corresponding CVD risk associated with elevated inflammation in persons with obesity.

The purpose of this study was to determine the effect of adding game design elements (goal setting, feedback, and external rewards) to an evidence-based physical activity intervention to increase in-class physical activity participation (intensity of activity breaks performed). Nine third- through sixth-grade classrooms (n = 292 students) in one elementary-middle school in Detroit, Michigan (49% female, 95% nonwhite; 80% qualified for free/reduced lunch) participated in this 20-week intervention where teachers implemented 5 × 4 min moderate-to-vigorous activity breaks per day. Gamification of activity breaks occurred during weeks 13–20 of the intervention and included the use of game design elements and classroom goals for activity break intensity. Moderate-to-vigorous physical activity (MVPA) during activity breaks was measured via direct observation. There was a significant effect of intervention with a 27% increase in student MVPA participation during the gamified intervention weeks compared with the standard intervention weeks (p = 0.03). Gamification of activity breaks resulted in 55% (compared with 25% during the standard intervention) of students accumulating approximately 20 min of health-enhancing physical activity per day in their classroom. These findings provide preliminary evidence that gamifying activity breaks may be an important strategy for increasing student participation in classroom activity breaks.

Environmental factors, including racial discrimination and low household education, predicted higher BMI in African American adolescents, particularly among girls. Longitudinal studies are needed to better understand the mechanisms by which these environmental factors increase obesity risk in African American youth.

Purpose: The purpose of this study was 2-fold: 1) to determine the cross-sectional associations between psychological stress, physical activity enjoyment, and physical activity participation [moderate-to-vigorous physical activity (MVPA), total physical activity (TPA)]; and 2) to determine the moderating effect of physical activity enjoyment on the associations between stress, MVPA, and TPA in adolescents with overweight/obesity. Design: Cross-sectional, secondary data analysis of the Health and Culture Project and the Stress, Obesity, and Diabetes in Adolescents study. Sample: One hundred and ten adolescents (73% female; 65.4% non-white; age 15.8 ± 1.9 years) with overweight/obesity (BMI percentile ≥ 85th percentile) were included in this analysis. Measures: Psychological stress was assessed using the Perceived Stress Scale (PSS-14); enjoyment was measured via the Physical Activity Enjoyment Scale; and MVPA and TPA were objectively measured using accelerometry over a minimum of 4 days. Results: Higher perceived stress was associated with lower physical activity enjoyment (β = −0.41 ± 0.15; p = 0.008). Stress was not associated with MVPA or TPA ( ps > 0.05), nor was enjoyment a significant moderator in the associations between stress and MVPA or stress and TPA ( pinteraction > 0.05). Conclusions: These findings suggest that psychological stress is associated with lower physical activity enjoyment among adolescents with overweight/obesity. Longitudinal studies are needed to understand the long-term effects of stress on psychological factors that may serve as antecedents to physical activity participation among adolescents with overweight/obesity.

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