Children in rural communities experience significant obesity-related health disparities; they are 26%?55% more likely to be obese and less likely to have health insurance and access to weight management specialists than are their urban peers. Geographic-specific disparities in obesity may be due, in part, to variations in energy intake (EI). Children in rural communities describe purchasing and consuming significantly more energy-dense, low-nutrient food items relative to their urban peers. Existing behavioral strategies for improving children's EI patterns have largely been ineffective in reducing risk for excess weight gain. The primary aim of the proposed study is to test the effects of a brief, novel strategy for improving rural children's daily EI. Specifically, the study aims to harness the well-documented benefits of an acute bout (20 min) of moderate physical exercise on children's executive functioning (EF), and to see if these cognitive changes lead to better self-regulation of EI. In a randomized crossover design, 90 preadolescent children (ages 8?10 y; 50% female; 50% obese) will complete two separate conditions (physical activity, sedentary control) on two separate days. In the physical activity condition, children will walk at a moderate pace on a treadmill for 20 min. In the sedentary condition, children will read magazines/books for 20 min. Immediately following each condition, children's EF will be assessed with a brief (3 min) inhibitory control task. EI will then be assessed during a large multi-array buffet test meal. If 20 min of moderate physical exercise is associated with observed improvements in preadolescent children's EI secondary to increases in EF, these data may offer explicit targets for an obesity prevention trial in rural Oregon elementary schools. Such a trial may include introducing 20 min of moderate physical exercise immediately before children's lunchtime food exposure. To begin exploring how experimental, mechanistic data from the proposed study could be scaled up in the natural school environment, qualitative data will also be collected from teachers, staff, and volunteers at an elementary school in rural Oregon as they begin the process of moving recess from immediately after to immediately before lunch. The Active Implementation Frameworks, an evidence-based implementation science tool, will assist with the development of a semi-structured interview to explore the barriers to, and facilitators of, effectively implementing this recess-related change. A team of 11?15 relevant school stakeholders will be approached to discuss organizational fit, need, resources, readiness, and capacity. This approach uses the Active Implementation Frameworks to strengthen the infrastructure for implementing a future effectiveness trial in the local context. A school-based obesity prevention trial in which a brief bout of physical exercise is introduced immediately before lunchtime food exposure would offer diffuse benefits with regard to children's health, well-being, and cognitive functioning; is likely to be well received by parents, staff, and policymakers; and may address significant geographic-related disparities in EI and obesity.
Children in rural communities experience significant obesity-related disparities and report worse eating habits than do their urban peers; as such, novel strategies for improving rural children's eating habits are needed. The proposed study will test the efficacy of a brief bout of moderate physical exercise to increase the executive functioning and subsequent self-regulation of the food consumption of preadolescent children in rural communities. A 20-min physical activity intervention introduced immediately before lunchtime food exposure in rural schools may prompt acute improvements in children's eating habits, thereby reducing their risk for excess weight gain and chronic disease development.
