Physical activity monitoring in Europe. The European Physical Activity Surveillance System (EUPASS) approach and indicator testing

Self-Reported Physical Activity and Mental Health Among Asylum Seekers in a Refugee Camp

BACKGROUND

Global forced displacement has been rising steeply since 2015 as a result of wars and human rights abuses. Forcibly displaced people are often exposed to physical and mental strain, which can cause traumatic experiences and poor mental health. Physical activity has been linked with better mental health, although such evidence is scarce among those populations. The purpose of the study was to examine the relationships of self-reported physical activity and fitness with mental health indices among people residing in a refugee camp in Greece as asylum seekers.

METHODS

Participants were 151 individuals (76 women, 75 men; mean age 28.90 y) displaced from their homes for an average of 32.03 months. Among them, 67% were from Afghanistan and countries from southwest Asia, and 33% from sub-Saharan African countries. Participants completed self-report measures assessing physical activity, fitness, symptoms of post-traumatic stress disorder, depression, anxiety, and well-being.

RESULTS

High prevalence of mental health disorder symptoms and poor well-being were identified, with women and Asians showing poorer mental health. Symptoms of post-traumatic stress disorder, depression, and anxiety were related to perceived fitness, but not to self-reported physical activity. Regression analysis showed that perceived fitness (β: 0.34; 95% CI, 0.43 to 1.52) and low-intensity physical activity (β: 0.24; 95% CI, 0.001 to 0.009) significantly positively predicted well-being, showing small to medium effect.

CONCLUSIONS

The findings provide useful insights regarding the link between physical activity and well-being; nevertheless, further research examining objectively measured physical activity is warranted to complement these data and further explore the associations between physical activity and mental health.

Audio-visual integration is more precise in older adults with a high level of long-term physical activity

It is well established that physical activity leads to numerous health, cognitive, and psychological benefits. However, to date, very few studies have investigated the impact of physical activity on multisensory perception, that is, the brain's capacity to integrate information across sensory modalities. Furthermore, it is unknown what level of long-term physical activity is associated with multisensory integration in adults. We explored the relationship between multisensory integration and a ten-year physical activity trajectory in 2,974 adults aged 50+ from The Irish Longitudinal Study on Ageing by measuring susceptibility to the Sound Induced Flash Illusion (SIFI) at multiple audio-visual temporal asynchronies. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ-SF) at 2 years intervals over ten years. We used latent class trajectory modelling to identify latent growth classes of individuals following a similar trajectory of physical activity over time. We analysed the association of this trajectory with performance accuracy to the illusion trials of the SIFI task with generalized logistic mixed effects regression models, adjusted for several covariates. Results showed that more precise integration (i.e., lower SIFI susceptibility with larger temporal asynchronies) was associated with a higher level of sustained physical activity across ten years. Although the use of self-reported physical activity and a short version of the SIFI task limit our conclusions to some extent, nonetheless, the results suggest that sustained physical activity is associated with more precise multisensory integration, which in turn is linked to better balance and a lower risk of falling in older adults.

Physical Activity Modifies the Severity of COVID-19 in Hospitalized Patients-Observational Study

BACKGROUND AND AIM

Physical activity (PA) can modulate the immune response, but its impact on infectious disease severity is unknown. We assess if the PA level impacts the severity of COVID-19.

METHODS

Prospective, cohort study for adults hospitalized due to COVID-19, who filled out the International Physical Activity Questionnaire (IPAQ). Disease severity was expressed as death, transfer to intensive care unit (ICU), oxygen therapy (OxTh), hospitalization length, complications, C-reactive protein, and procalcitonin level.

RESULTS

Out of 326 individuals, 131 (57; 43.51% women) were analyzed: age: median-70; range: 20-95; BMI: mean-27.18 kg/m²; and SD: ±4.77. During hospitalization: 117 (83.31%) individuals recovered, nine (6.87%) were transferred to ICU, five (3.82%) died, and 83 (63.36%) needed OxTh. The median for the hospital stay was 11 (range: 3-49) for discharged patients, and mean hospitalization length was 14 (SD: ±5.8312) for deaths and 14.22 days (SD: ±6.92) for ICU-transferred patients. The median for MET-min/week was 660 (range: 0-19,200). Sufficient or high PA was found in recovered patients but insufficient PA was observed in dead or ICU-transferred patients (p = 0.03). The individuals with poor PA had a higher risk of death (HR = 2.63; ±95%CI 0.58-11.93; p = 0.037). OxTh was used more often in the less active individuals (p = 0.03). The principal component analysis confirmed a relationship between insufficient PA and an unfavorable course of the disease.

CONCLUSION

A higher level of PA is associated with a milder course of COVID-19.

Physical Fitness and Motor Competence in Chinese and German Elementary School Children in Relation to Different Physical Activity Settings

(1) Background: Children with greater physical activity (PA) may show a higher physical fitness (PF) and motor competence (MC) compared to peers with less PA. The purpose of this study was to examine the relationship between moderate-to-vigorous physical activity (MVPA), PF, and MC in 8- to 9-year old children in Germany and China. MVPA was differentiated into five PA settings: family sport, club training, school sport, leisure sport, and outside play. (2) Methods: This longitudinal study comprised N = 577 children (n = 311 girls, n = 266 boys) who were studied over a one-year period. Each child's PF and MC was determined using sports motor tests. The children's PAs were measured using a questionnaire. (3) Results: The children's PA was positively associated with PF and MC. The MVPA-settings: family sport, leisure sport, outside play, school, and club sport, explained between 18 and 23 percent of the variance in selected PF and MC characteristics in a multivariate linear regression analysis. (4) Conclusions: An increase in the children's MVPA might be an appropriate aim in the school sport in Germany as well as in the club sport system in China. Furthermore, family sport should be enhanced in Germany and outside play activities in China, respectively.

Validity and Reliability of IPAQ-SF and GPAQ for Assessing Sedentary Behaviour in Adults in the European Union: A Systematic Review and Meta-Analysis

Current lifestyles are marked by sedentary behaviour; thus, it is of great importance for policymaking to have valid and reliable tools to measure sedentary behaviour in order to combat it. Therefore, the aim of this review and meta-analysis is to critically review, assess, and compile the reliability, criterion validity, and construct validity of the single-item sedentary behaviour questions within national language versions of most commonly used international physical activity questionnaires for adults in the European Union: The International Physical Activity Questionnaire-Short Form and the Global Physical Activity Questionnaire. A total of 1749 records were screened, 287 full-text papers were read, and 14 studies were included in the meta-analysis. The results and quality of studies were evaluated by the Quality Assessment of Physical Activity Questionnaires checklist. Meta-analysis indicated moderate to high reliability (r_w = 0.59) and concurrent validity (r_w = 0.55) of national language versions of single-item sedentary behaviour questions. Criterion validity was rather low (r_w = 0.23) but in concordance with previous studies. The risk of bias analysis highlighted the poor reporting of methods and results, with a total bias score of 0.42. Thus, we recommend using multi-item SB questionnaires and smart trackers for providing information on SB rather than single-item sedentary behaviour questions in physical activity questionnaires.

Functional fitness normative values for elderly polish population

Background

It’s really important to measure the actual functional physical fitness of elderly independent living persons from different environments to know the level and rate of decrease may inform about the threat of loss of functional independence, hence the need to monitor and assess the senior’s motor realm and adapt to it the appropriate programs and treatments in the care for the elderly person.

Methods

The study involved 5367 people (mean age 69,63 ± 7,06), including 4164 women (mean age 69,55 ± 7,11) and 1203 men (mean age 69,91 ± 6,86) aged 60 to 93 years old. We have measured basic anthropometric features and physical fitness (by using Senior Fitness Test).

Results

The average values in individual SFT tests significantly decrease along with age. After age of 80 and 85 there were no sex differences in SFT. The largest deficits concern the dynamic balance and the decrease reaches 69% in men and 62% in women A significantly higher rate of decline in aerobic capacity concerns men (43%) than women (36.9%). A clearly lower rate of loss occurs in the muscular strength of the lower and upper body and does not exceed 30%.

Conclusions

The results are of great clinical importance for the development of effective prevention and gerontological education programs in terms of promoting active lifestyle and successful ageing, at the same time limiting the economic consequences of treatment and hospitalisation.

Validity and Reliability of International Physical Activity Questionnaires for Adults across EU Countries: Systematic Review and Meta Analysis

This review and meta-analysis (PROSPERO registration number: CRD42020138845) critically evaluates test-retest reliability, concurrent validity and criterion validity of different physical activity (PA) levels of three most commonly used international PA questionnaires (PAQs) in official language versions of European Union (EU): International Physical Activity Questionnaire (IPAQ-SF), Global Physical Activity Questionnaire (GPAQ), and European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ). In total, 1749 abstracts were screened, 287 full-text articles were identified as relevant to the study objectives, and 20 studies were included. The studies' results and quality were evaluated using the Quality Assessment of Physical Activity Questionnaires checklist. Results indicate that only ten EU countries validated official language versions of selected PAQs. A meta-analysis revealed that assessment of moderate-to-vigorous PA (MVPA) is the most relevant PA level outcome, since no publication bias in any of measurement properties was detected while test-retest reliability was moderately high (r_w = 0.74), moderate for the criterion (r_w = 0.41) and moderately-high for concurrent validity (r_w = 0.72). Reporting of methods and results of the studies was poor, with an overall moderate risk of bias with a total score of 0.43. In conclusion, where only self-reporting of PA is feasible, assessment of MVPA with selected PAQs in EU adult populations is recommended.

Physical activity levels in men with Haemophilia-A single centre UK survey

INTRODUCTION

Historically persons with haemophilia (PWH) were not encouraged to participate in exercise due to the risk of bleeding and the lack of factor products available. This has now changed, and the availability of safe products allows PWH to be active and participate in sports. Studies have found that exercise has a positive effect on pain, joint health and movement with PWH.

AIM

To record the amount and types of physical activity undertaken by a haemophilia population at a single treatment centre.

METHODS

An observational cross-sectional study to assess physical activity and quality of life of all registered patients over the age of 18 at the Oxford Haemophilia and Thrombosis Centre. Participants were posted questionnaires including the International Physical activity Questionnaire (IPAQ), Haemophilia Activity List (HAL), EQ-5D-5L and asked to list their physical activities.

RESULTS

A total of 256 questionnaires were sent, with a 40% response rate for severe and 28% for mild patients. 85% met the UK physical activity guidelines. Sedentary behaviour for an average weekday was 6.4 hours, and weekends were 5.3 hours. Joint disease and severity type influenced the amount of activity undertaken, together with values for HAL and EQ-5D-5L. Twenty two types of activities were listed.

CONCLUSION

It is encouraging to see the amount of physical activity PWH participate in, however, time spent in a sedentary state needs monitoring. PWH want to be active and the challenge for caregivers is to find activities they can do and strategies to maintain participation.

A systematic literature review of reviews on techniques for physical activity measurement in adults: a DEDIPAC study

The links between increased participation in Physical Activity (PA) and improvements in health are well established. As this body of evidence has grown, so too has the search for measures of PA with high levels of methodological effectiveness (i.e. validity, reliability and responsiveness to change). The aim of this “review of reviews” was to provide a comprehensive overview of the methodological effectiveness of currently employed measures of PA, to aid researchers in their selection of an appropriate tool. A total of 63 review articles were included in this review, and the original articles cited by these reviews were included in order to extract detailed information on methodological effectiveness.

Self-report measures of PA have been most frequently examined for methodological effectiveness, with highly variable findings identified across a broad range of behaviours. The evidence-base for the methodological effectiveness of objective monitors, particularly accelerometers/activity monitors, is increasing, with lower levels of variability observed for validity and reliability when compared to subjective measures. Unfortunately, responsiveness to change across all measures and behaviours remains under-researched, with limited information available.

Other criteria beyond methodological effectiveness often influence tool selection, including cost and feasibility. However, researchers must be aware of the methodological effectiveness of any measure selected for use when examining PA. Although no “perfect” tool for the examination of PA in adults exists, it is suggested that researchers aim to incorporate appropriate objective measures, specific to the behaviours of interests, when examining PA in free-living environments.

Association of socioeconomic, school-related and family factors and physical activity and sedentary behaviour among adolescents: multilevel analysis of the PRALIMAP trial inclusion data

BACKGROUND

Social differences among adolescents in physical activity and sedentary behaviour have been identified but are not well explained. The current study aimed to identify socioeconomic, family and school-related associated factors with physical activity and sedentary behaviour among high-school adolescents.

METHODS

This was a cross-sectional analysis of T0 physical activity and sedentary behaviour of 2523 students 14 - 18 years old recruited for the PRALIMAP trial from 24 French state-run high schools. Data were collected by self-administered questionnaire at the start of grade 10. Adolescents completed the International Physical Activity Questionnaire for physical activity and sedentary behaviour and an ad hoc questionnaire for active commuting and sport participation. Statistical analyses involved linear and logistic regressions.

RESULTS

Socioeconomic, family or school variables were associated with levels of physical activity and sedentary behaviour for both boys and girls, but no factor, except perceived parental physical activity level, was associated with total energy expenditure (total physical activity) for either gender. Adolescents with privileged and less privileged socioeconomic status reported the same total amount of energy expenditure.

CONCLUSIONS

Total physical activity score alone is not sufficient to assess the physical activity of adolescents. These findings may have implications for better understanding of social inequalities in this context and recommendations to prevent overweight.

TRIAL REGISTRATION

This trial is registered at ClinicalTrials.gov ( NCT00814554 ). The date of registration: 23 December 2008. Registration was not required at the time of the start of PRALIMAP for public health and prevention programmes and trials.

Variation in population levels of physical activity in European children and adolescents according to cross-European studies: a systematic literature review within DEDIPAC

BACKGROUND

Regular physical activity is associated with physical, social and mental health benefits, whilst insufficient physical activity is associated with several negative health outcomes (e.g. metabolic problems). Population monitoring of physical activity is important to gain insight into prevalence of compliance to physical activity recommendations, groups at risk and changes in physical activity patterns. This review aims to provide an overview of all existing studies that measure physical activity in youth, in cross-European studies, to describe the variation in population levels of physical activity and to describe and define challenges regarding assessment methods that are used.

METHODS

A systematic search was performed on six databases (PubMed, EMBASE, CINAHL, PsycINFO, SportDiscus and OpenGrey), supplemental forward- and backward tracking was done and authors' and experts' literature databases were searched to identify relevant articles. Journal articles or reports that reported levels of physical activity in the general population of youth from cross-European studies were included. Data were reviewed, extracted and assessed by two researchers, with disagreements being resolved by a third researcher. The review protocol of this review is published under registration number CRD42014010684 in the PROSPERO database.

RESULTS

The search resulted in 9756 identified records of which 30 articles were included in the current review. This review revealed large differences between countries in prevalence of compliance to physical activity recommendations (i.e. 60 min of daily moderate- to vigorous-intensity physical activity (MVPA)) measured subjectively (5-47%) and accelerometer measured minutes of MVPA (23-200 min). Overall boys and children were more active than girls and adolescents. Different measurement methods (subjective n = 12, objective n = 18) and reported outcome variables (n = 17) were used in the included articles. Different accelerometer intensity thresholds used to define MVPA resulted in substantial differences in MVPA between studies conducted in the same countries when assessed objectively.

CONCLUSIONS

Reported levels of physical activity and prevalence of compliance to physical activity recommendations in youth showed large variation across European countries. This may reflect true variation in physical activity as well as variation in assessment methods and reported outcome variables. Standardization across Europe, of methods to assess physical activity in youth and reported outcome variables is warranted, preferably moving towards a pan-European surveillance system combining objective and self-report methods.

Efficacy of a web-based, center-based or combined physical activity intervention among older adults

With more social support and environment-centered interventions being recommended in web-based interventions, this study examined the efficacy of three intervention conditions aimed at promoting physical activity (PA) in older adults. The efficacy analyses included the self-reported PA level, stage of change for PA and awareness about PA among participants. Eligible participants (N = 149; M = 65 years old, SD = 6), recruited in a unique Belgian French-speaking municipality, were randomized in four research arms for a 3-month intervention: (i) web-based; (ii) center-based; (iii) mixed (combination of web- and center-based); and (iv) control (no intervention). Web-based condition included a PA website and monthly tailored emails whereas center-based condition comprised 12 sessions (1 per week) of group exercising. With a significant increase in PA, the PA stage of change and the PA awareness at 12 months, the mixed intervention condition seemed to include the key social and motivating elements for sustainable behavior change. Center-based intervention was more likely to produce significant improvements of the PA level and the stage of change for PA change whereas web-based intervention was more likely to extend the awareness about PA.

Adherence to physical activity recommendations and its associated factors: an interregional population-based study

Background

Though the influence of physical activity in preventing cardiovascular diseases is well documented, only a few comparative studies have determined the degree of adherence to physical activity recommendations among populations and identified the demographic, socioeco-nomic, behavioural and health-related factors associated with good compliance.

Design and methods

Cross-sectional interregional NESCaV survey of 3133 subjects compared three populations, Luxembourg, Lorraine (France) and Wallonia (Belgium), by using the International Physical Activity Questionnaire. Age and gender prevalence rates of physical activity were standardized to the European population.

Results

The likelihood to meet the recommendations was higher in Luxembourg, after adjustment for age, gender, education, employment, weight status, morbidity score, health perception and level of importance attributed to the practice of physical activity (P<0.0001). The odds for meeting the recommendations were significantly higher among those with secondary than tertiary education. Compared to good self-health perception, subjects with poor or fair self-perceived health were less likely to meet the recommendations; this also applied to those attributing little or enough importance to physical activity compared with great importance.

Conclusions

Region, education, self-perceived health and perception of importance of physical activity were emerged as independent determinants of meeting the recommendations. Awareness of the positive health effects of physical activity might thus be crucial for motivating the people to become more active. Further research is needed to explore potential region-specific factors which might explain the difference in population behaviours with respect to physical activity.

Comparison of self-reported versus accelerometer-measured physical activity

INTRODUCTION

The International Physical Activity Questionnaire (IPAQ) is one of the most widely used questionnaires to assess physical activity (PA). Validation studies for the IPAQ have been executed, but still there is a need for studies comparing absolute values between IPAQ and accelerometer in large population studies.

PURPOSE

To compare PA and sedentary time from the self-administered, short version of the IPAQ with data from ActiGraph accelerometer in a large national sample.

METHODS

A total of 1751 adults (19-84 yr) wore an accelerometer (ActiGraph GT1M) for seven consecutive days and completed the IPAQ-Short Form. Sedentary time, total PA, and time spent in moderate to vigorous activity were compared in relation to sex, age, and education.

RESULTS

Men and women reported, on average, 131 min·d (SE = 4 min·d) less sedentary time compared with the accelerometer measurements. The difference between self-reported and measured sedentary time and vigorous-intensity PA was greatest among men with a lower education level and for men 65 yr and older. Although men reported 47% more moderate to vigorous physical activity (MVPA) compared with women, there were no differences between sexes in accelerometer-determined MVPA. Accelerometer-determined moderate PA was reduced from 110 to 42 min·d (62%) when analyzed in blocks of 10 min (P < 0.0001) compared with 1-min blocks. The main correlation coefficients between self-reported variables and accelerometer measures of physical activity were between 0.20 and 0.46.

CONCLUSIONS

The participants report through IPAQ-Short Form more vigorous PA and less sedentary time compared with the accelerometer. The difference between self-reported and accelerometer-measured MVPA increased with higher activity and intensity levels. Associations between the methods were affected by sex, age, and education, but not body mass index.

The independent relations of both residential self-selection and the environment to physical activity

Residential self-selection is supposed to bias the relation between residential environments and physical activity, but empirical analyses are still rare. This study examines the association while simultaneously considering the effect of residential self-selection criteria. One thousand two hundred and forty-five German students were asked to report their physical activity, their perceived environment, and their reasons for choosing their neighbourhood. Structural equation modelling was employed. Reasons for choosing a neighbourhood were related to actual environmental characteristics. Utilitarian reasons were related to less physical activity, hedonic reasons were related to higher physical activity. The street network was related to higher physical activity independent of residential self-selection. Our results support the weight of both individual preferences and the street network on physical activity. The residential environment has an impact on people's amount of physical activity regardless of their reasons for choosing a neighbourhood and should therefore be considered a resource in health prevention and promotion.

Reliability of the Serbian version of the International Physical Activity Questionnaire for older adults

The purpose of this study was to determine the test-retest reliability of the International Physical Activity Questionnaire (IPAQ) for older adults in Serbia. Six hundred and sixty older adults (352 men, 53%; 308 women, 47%; mean age 67.65±5.76 years) participated in the study. To examine test-retest reliability, the participants were asked to complete the IPAQ on two occasions 2 weeks apart. Moderate reliability was observed between the repeated IPAQ, with intraclass correlation coefficients ranging from 0.53 to 0.91. The least reliability was established in leisure time activity (0.53) and the most reliability in the transport domain (0.91). Men and women had similar intraclass correlation coefficients for total physical activity (0.71 versus 0.74, respectively), while the biggest difference was obtained for housework in men (0.68) and in women (0.90). Our study shows that the long version of the IPAQ is a reliable instrument for assessing physical activity levels in older adults and that it may be useful for generating internationally comparable data.

A randomised controlled trial testing a web-based, computer-tailored self-management intervention for people with or at risk for chronic obstructive pulmonary disease: a study protocol

BACKGROUND

Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality. Effective self-management support interventions are needed to improve the health and functional status of people with COPD or at risk for COPD. Computer-tailored technology could be an effective way to provide this support.

METHODS/DESIGN

This paper presents the protocol of a randomised controlled trial testing the effectiveness of a web-based, computer-tailored self-management intervention to change health behaviours of people with or at risk for COPD. An intervention group will be compared to a usual care control group, in which the intervention group will receive a web-based, computer-tailored self-management intervention. Participants will be recruited from an online panel and through general practices. Outcomes will be measured at baseline and at 6 months. The primary outcomes will be smoking behaviour, measuring the 7-day point prevalence abstinence and physical activity, measured in minutes. Secondary outcomes will include dyspnoea score, quality of life, stages of change, intention to change behaviour and alternative smoking behaviour measures, including current smoking behaviour, 24-hour point prevalence abstinence, prolonged abstinence, continued abstinence and number of quit attempts.

DISCUSSION

To the best of our knowledge, this will be the first randomised controlled trial to test the effectiveness of a web-based, computer-tailored self-management intervention for people with or at risk for COPD. The results will be important to explore the possible benefits of computer-tailored interventions for the self-management of people with or at risk for COPD and potentially other chronic health conditions.

DUTCH TRIAL REGISTER

NTR3421.

Physical activity patterns and socioeconomic position: the German National Health Interview and Examination Survey 1998 (GNHIES98)

Background

We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98). The roles of income level, occupational status and other mediating variables for these associations were also examined.

Methods

The total study sample of the GNHIES98 comprised 7,124 participants between the ages of 18 and 79. Complete information was available for 6,800 persons on leisure-time, sedentary and total physical-activity outcomes and for 3,809 persons in regular employment on occupational activity outcomes. The associations between educational level and physical activity (occupational, sedentary, leisure-time and total physical activity) were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of educational level on physical-activity outcomes were calculated and adjusted for age, region, occupation, income and other mediating variables.

Results

After adjusting for age and region, a higher education level was associated with more leisure-time activity – with an OR of 1.6 (95% CI, 1.3-2.0) for men with secondary education and 2.1 (1.7-2.7) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.3 (1.1-1.6) and 1.7 (1.2-2.4), respectively. Higher education was associated with a lower level of vigorous work activity: an OR of 6.9 (4.6-10.3) for men with secondary education and 18.6 (12.0-27.3) for men with primary education compared to men with tertiary education. The corresponding ORs for women were 2.8 (2.0-4.0) and 5.8 (4.0-8.5), respectively. Higher education was also associated with a lower level of total activity: an OR of 2.9 (2.2-3.8) for men with secondary education and 4.3 (3.3-5.6) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.6 (1.2-2.0) and 1.6 (1.2-2.1), respectively.

Conclusions

In Germany adults with a lower level of education are more physically active, both at work and overall, compared to adults with a higher education level, although they are less physically active in their leisure time. Higher work-related activity levels among adults with lower education may explain why they are less active in their leisure time.

Physical activity patterns in the French 18-74-year-old population: French Nutrition and Health Survey (Etude Nationale Nutrition Santé, ENNS) 2006-2007

OBJECTIVE

To describe detailed physical activity and sedentary behaviour in French adults across physical activity categories.

DESIGN

The French Nutrition and Health Survey (Etude Nationale Nutrition Santé, ENNS), conducted in 2006-2007, was a national cross-sectional survey based on three-stage random sampling. The International Physical Activity Questionnaire (IPAQ) was used to classify participants into three physical activity categories. Time spent in a sitting position and time spent in front of a screen were used as markers of sedentary behaviour.

SETTING

France.

SUBJECTS

Adults (n 2971) aged 18 to 74 years were included.

RESULTS

Overall, 29·5 % of men and 23·6 % of women were classified into the high-IPAQ category, while 36·1 % of men and 37·5 % of women were in the low-IPAQ category. For each intensity level of physical activity (vigorous intensity, moderate intensity or walking), the number of active days per week decreased from the high- to the low-IPAQ category and daily duration of physical activity was longer in the high-IPAQ category than in the other two categories; 6 % of adults declared neither vigorous nor moderate nor walking activities.

CONCLUSIONS

For most adults in the low-IPAQ category, an increasing number of active days per week would be sufficient to attain the moderate-IPAQ category. This should be taken into account in public health initiatives aimed at promoting physical activity.

Reliability and validity of the International Physical Activity Questionnaire (IPAQ) in elderly adults: the Fujiwara-kyo Study

Background

The International Physical Activity Questionnaire (IPAQ) is a self-reported questionnaire for assessing physical activity and has been tested in 12 countries among adults aged 18 to 65 years. The present study evaluated the reliability and validity of the IPAQ among adults aged 65 years and older.

Methods

The study included 164 men and 161 women selected from participants of the Fujiwara-kyo Study, a prospective cohort of elderly Japanese adults. To examine test–retest reliability, the participants were asked to complete the IPAQ twice, 2 weeks apart. The criterion validity of the IPAQ was tested by using an accelerometer.

Results

Based on intraclass correlation coefficients, the reliability of the total IPAQ was 0.65 and 0.57 for men and women, respectively, aged 65 to 74 years and 0.50 and 0.56 for those aged 75 to 89 years. The Spearman correlation coefficients between total IPAQ score and total physical activity measured by accelerometer (TPA-AC) were 0.42 and 0.49 for men and women, respectively, aged 65 to 74 and 0.53 and 0.49 for those aged 75 to 89. Weighted kappa coefficients between total IPAQ score and TPA-AC were 0.49 and 0.39 for men and women, respectively, aged 65 to 74 and 0.46 and 0.47 for those aged 75 to 89.

Conclusions

The reliability of the IPAQ was not sufficient, but the validity was adequate. Although there were some limitations with regard to repeatability and agreement in classification, the IPAQ was a useful tool for assessing physical activity among elderly adults.

Comparison of the modified Chinese Baecke Questionnaire with a 3-day activity diary in a Hong Kong Chinese population

The aim of this study was to determine the reliability and validity of the modified Chinese Baecke Questionnaire, using a 3-day activity diary as a reference, in Hong Kong Chinese population. A total of 198 Chinese subjects aged 18 to 65 years were recruited in Hong Kong. Validity of the questionnaire was assessed using a 3-day activity diary as the reference method. Two-week test-retest reliability was also evaluated. Good reliability for the modified Chinese Baecke Questionnaire was demonstrated (correlation coefficients ranged from 0.65 to 0.90). Cohen's κ was 41.0% for men and 56.7% for women. High correlation between the weighted total index computed from the questionnaire and daily energy expenditure obtained from the diaries (r = 0.61) was demonstrated (r = 0.56, P < .01 for men and r = 0.59, P < .01 for women). Overall, 2.1% and 4.8% gross misclassifications were found for men and women, respectively. In conclusion, the modified Chinese Baecke Questionnaire was found to be reliable and valid for measuring habitual physical activity in the Hong Kong Chinese adult population.

Prevalence of dementia in mountainous village of Sicily

The progressive and rapid aging of population is the demographic characteristic in the Western countries. This rapid process of aging is causing an increasing burden on the social and health-care services. In this context, the precise knowledge of the environmental, socio-economical and clinical characteristics of the elderly population is mandatory to find the correct strategies to achieve the successful aging. Our study aimed to investigate the functional and clinical characteristics of the elderly (aged 60 to 85 years) of San Teodoro (1500 inhabitants), a rural village of Central Sicily, in particularly considering the dementia prevalence. In 2005, all the elderly between 60 and 85 years old were invited to participate to the study. The list of the potential participants was obtained from the Registry office of the municipality. The final number of the eligible subjects was 374. Rate of participation was 74.9% (280 subjects, 120 M and 160 F). The study was conducted door-to-door. Dementia prevalence was 7.1% (20 subjects, 8 M and 12 F), with 60% Alzheimer's disease and 15% vascular dementia, slightly higher than that of the European countries (6%). The high prevalence of hypertension (80.3%) and the low education level, two important risk factors for dementia, could explain in part the difference observed.

Reliability and validity of the international physical activity questionnaire in the Nord-Trøndelag health study (HUNT) population of men

BACKGROUND

There is no standardized method for the assessment of physical activity (PA). Therefore it is important to investigate the validity and comparability of different measures. The International Physical Activity Questionnaire (IPAQ) has been developed as an instrument for cross-national assessment of PA and has been validated in 12 countries. These instruments have acceptable measurement properties for monitoring population levels of PA among 18-65 year-old adults in diverse settings. However, there are some concerns that IPAQ may over-report PA.The purpose of this study is to evaluate the reliability and validity of IPAQ, short version, last 7-days in the Nord-Trøndelag Health Study (HUNT) population of men.

METHODS

The questionnaire was administered twice to a random sample of 108 men aged 20-39 and validity by comparing results with VO2max and ActiReg, an instrument that measures PA and energy expenditure (EE). ActiReg discriminates between the body positions: stand, sit, bend forward and lie and also registers if there is motion or not in each of them or both.

RESULTS

Our results for reliability of the IPAQ short version were good for vigorous and fair for moderate activities. Intraclass correlations ranged from a low of 0.30 for moderate activity hours, to a high of 0.80 for sitting hours. Concerning validity, our results suggest that total IPAQ vigorous PA was a moderately good measure of vigorous activity, having moderately strong, significant correlations with VO2max, r = 0.41 (p < or = 0.01), but correlated not with metabolic equivalent (METs) values of 6 or more measured with ActiReg. Only total IPAQ walking was fair correlated with METs 1-3 and METs 3-6, respectively r = -0.27 and 0.26 (p < or = 0.05). The index for IPAQ sitting hours per week was moderate correlated with METs values of 1-3 and negatively correlated with METs values of 3-6. Classification of PA in three levels (low, moderate and high) correlated also most strongly with VO2max (0.31 p < or = 0.01) and METs 3-6 and METs 1-3 from ActiReg (r = 0.32 and -0.31, p < or = 0.01). Classification of BMI in three levels (normal, overweight and obese) correlated most strongly negative with VO2max (-0.42 p < or = 0.01) and MJ from ActiReg (r = 0.31 p < or = 0.01).

CONCLUSION

Our results indicate that IPAQ short version for men has acceptable reliability and criterion validity for vigorous activity and sitting. Walking has moderate reliability. Only the IPAQ for walking had a fair correlation with METs 6+. The questions about moderate activity had fair reproducibility and correlated poorly with most comparison measures.

Italian network for obesity and cardiovascular disease surveillance: a pilot project

Background

Also in Mediterranean countries, which are considered a low risk population for cardiovascular disease (CVD), the increase in body mass index (BMI) has become a public health priority. To evaluate the feasibility of a CVD and obesity surveillance network, forty General Practitioners (GPs) were engaged to perform a screening to assess obesity, cardiovascular risk, lifestyle habits and medication use.

Methods

A total of 1,046 women and 1,044 men aged 35–74 years were randomly selected from GPs' lists stratifying by age decade and gender. Anthropometric and blood pressure measurements were performed by GPs using standardized methodologies. BMI was computed and categorized in normal weight (BMI 18.5–24.9 kg/m²), overweight (BMI 25.0–29.9 kg/m²) and obese (BMI ≥ 30 kg/m²). Food frequency (per day: fruits and vegetables; per week: meat, cheese, fish, pulses, chocolate, fried food, sweet, wholemeal food, rotisserie food and sugar drink) and physical activity (at work and during leisure time) were investigated through a questionnaire. CVD risk was assessed using the Italian CUORE Project risk function.

Results

The percentage of missing values was very low. Prevalence of overweight was 34% in women and 50% in men; prevalence of obesity was 23% in both men and women. Level of physical activity was mostly low or very low. BMI was inversely associated with consumption of pulses, rotisserie food, chocolate, sweets and physical activity during leisure time and directly associated with consumption of meat. Mean value of total cardiovascular risk was 4% in women and 11% in men. One percent of women and 16% of men were at high cardiovascular risk (≥ 20% in 10 years). Normal weight persons were four times more likely to be at low risk than obese persons.

Conclusion

This study demonstrated the feasibility of a surveillance network of GPs in Italy focusing on obesity and other CVD risk factors. It also provided information on lifestyle habits, such as diet and physical activity.

Relation of leisure time, occupational, domestic, and commuting physical activity to health indicators in Europe

OBJECTIVES

To investigate relationships between physical activities in different domains (leisure time, occupational, domestic, commuting) and health indicators (self-rated health, body mass index).

METHODS

The short version of the International Physical Activity Questionnaire (IPAQ) and additional questions on domain specific physical activity were submitted face-to-face to 29,193 individual's age 15 years and older in the 27 member states of the Europe Union, 2 affiliated nations (Croatia, Turkey), and Cyprus North in 2005 as part of Eurobarometer 64.3.

RESULTS

Leisure time physical activity (compared to no leisure time physical activity) was positively associated with self-rated health (males: Odds Ratio (OR)=2.85, 95% Confidence Interval (CI): 2.27, 3.58; females: OR=2.77, 95% C.I. 2.16, 3.56) and inversely with obesity (males: OR=0.65, 95% C.I. 0.50, 0.83; females: OR=0.46, 95% C.I. 0.34, 0.63). Being in the highest quartile of the total volume of physical activity expressed using metabolic equivalents (in MET-min/week) (compared to being in the lowest quartile) was not related to self-rated health (males: OR=0.99, 95% C.I. 0.81, 1.21; females: OR=1.19, 95% C.I 0.98, 1.43) or obesity (males: OR=1.25, 95% C.I., 0.99, 1.59; females: OR=1.26, 95% C.I. 1.02, 1.57). Gender-specific effects were observed for other domains of physical activity. Analysis on national levels showed pronounced relationships of leisure time physical activity to health indicators.

CONCLUSIONS

Domains of physical activity being related to health indicators, they may pertain to surveillance.

Association of perceived environment with meeting public health recommendations for physical activity in seven European countries

BACKGROUND

This study investigates the association of perceived environment and meeting the current public health recommendations (PHRs) for physical activity (PA) and examines the role of body mass index (BMI) in this relation.

METHODS

A total of 4231 subjects (>or=18 years), from seven European countries, were involved in a cross-sectional survey. PA was measured by the International PA Questionnaire, and specific questions about perceived environment for PA were added.

RESULTS

Adults with high personal motivation were more likely to meet PHRs for PA than those without motivation (odds ratio [OR] 1.79; 95% confidence interval [CI] 1.50-2.14). Participants perceiving high social support from work or school were more likely to meet PHRs for PA than those without this support (OR 1.60; 95% CI 1.30-2.00). Likewise, those with perceived opportunities for PA were more likely to meet PHRs than those without this perception (OR 1.23; 95% CI 1.02-1.50). BMI had no effect on meeting PHRs for PA.

CONCLUSION

The study shows a relation between personal motivation and some aspects of social and physical environment in meeting current PHRs for PA. Future research involving an objective environment to meet PHRs for PA should be undertaken to validate these findings.

Assessment of physical activity and energy expenditure in epidemiological research of chronic diseases

Physical inactivity has emerged as an important risk factor for a number of diseases, but the typically crude exposure assessments in epidemiological studies, with entailing variation in measurement accuracy, may be a source of heterogeneity contributing to inconsistent results among studies. Consequently, the choice of method for the assessment of physical activity in epidemiological studies is important. Good methods increase our chances of avoiding misclassification and may enhance our understanding of the association between physical activity and health. Since physical activity is also a potential confounder of other lifestyle-health relationships, good methods may enhance our ability to control for confounding. But despite a steadily increasing selection of methods to choose from, no method is suitable for every situation and every population. Although the questionnaire is the most widely used method in epidemiological studies, and laboratory methods are mainly used for validation purposes, improved technology may change our ways of assessing physical activity in the future. This paper describes different methods to measure physical activity and energy expenditure from the epidemiological perspective, and attempts to address the concepts related to the measurement of physical activity.

Healthy Lifestyle by Nutrition in Adolescence (HELENA). A New EU Funded Project

The key to health promotion and disease prevention in the 21st century is to establish an environment that supports positive health behaviour and healthy lifestyle from childhood. The HELENA project includes cross-sectional, crossover and pilot community intervention multi-centre studies, as an integrated approach to the above-mentioned problem. Dietary intake, nutrition knowledge and eating attitudes, food choices and preferences, body composition, biochemical, physical activity and fitness and genotype (to analyse gene-nutrient and gene-environment interactions) assessment will provide the full information about the nutritional and lifestyle status of the European adolescents. The requirements for health promoting foods will be also identified, and three sensory acceptable products for adolescents will be developed. Harmonization and standardisation of the assessments for both scientific and technological objectives should result in reliable and comparable data of a representative sample of European adolescents. This will contribute to understand why health-related messages are not being as effective as expected in the adolescent population. A realistic intervention strategy will be proposed in order to achieve the goals of understanding and effectively enhancing nutritional and lifestyle habits of adolescents in Europe.

Association of vitamin B12, folate and homocysteine with functional and pathological characteristics of the elderly in a mountainous village in Sicily

Homocysteine is associated with age, folate and vitamin B

Subjects (n=280) were examined after door-to-door recruitment using interview, physician examination and laboratory tests.

A total of 19.3% of the population had a low blood level of folate (<7 nmol/L) and 3.2% had low vitamin B

The prevalence of deficits in folate and vitamin B

Clin Chem Lab Med 2007;45:136–42.

Comparison of the 2001 BRFSS and the IPAQ Physical Activity Questionnaires

PURPOSE

The 2001 Behavioral Risk Factor Surveillance System (BRFSS) physical activity module and the International Physical Activity Questionnaire (IPAQ) are used in population studies to determine the prevalence of physical activity. The comparability of the prevalence estimates has not been compared in U.S. adults. This study compares the physical activity prevalence estimates from the BRFSS and the IPAQ.

METHODS

A telephone survey was administered to a random sample of 11,211 U.S. adults aged 18-99 yr who were enrolled in the National Physical Activity and Weight Loss Survey. Data were analyzed from 9945 adults who provided complete data on the BRFSS and the IPAQ. Prevalence estimates were computed (1) applying the BRFSS scoring scheme for both questionnaires (2). Kappa statistics were used to compare prevalence estimates generated from the BRFSS and the IPAQ.

RESULTS

When scored using the BRFSS protocol, agreement between physical activity categories was fair (kappa = 0.34-0.49). Prevalence estimates were higher on the IPAQ than the BRFSS for the lowest category (inactive) by 0.1-3.9% and for the highest category (meets recommendations) by 0.2-9.7%. When scored using their own scoring, agreement between physical activity categories was lower (kappa = 0.26-0.39). The prevalence estimates on the IPAQ were higher than on the BRFSS for the lowest physical activity category by 0.2-13.3% and for the highest physical activity category by 0-16.4%. Differences in physical activity categories were observed for sex, age, income, education, and body mass index on both questionnaires.

CONCLUSION

Because of differences in the physical activity prevalence estimates, direct comparison of the BRFSS and IPAQ prevalence estimates is not recommended.

Intra-national variation in trends in overweight and leisure time physical activities in The Netherlands since 1980: stratification according to sex, age and urbanisation degree

OBJECTIVE

To investigate time trends in overweight and Leisure Time Physical Activities (LTPA) in The Netherlands since 1980. Intra-national differences were examined stratified for sex, age and urbanisation degree.

SUBJECTS AND METHODS

We used a random sample of about 140,000 respondents aged 20-69 years from the Health Interview Survey (Nethhis) and subsequent Permanent Survey on Living Conditions (POLS). Self-reported data on weight and height and demographic characteristics were gathered through interviews (every year) and data on LTPA were collected by self-administered questionnaires (1990-1997, 2001-2004). Linear regression analysis was performed for trend analyses.

RESULTS

During 1981-2004, mean body mass index (BMI) increased significantly by 1.0 kg/m(2) (average per year=0.05 kg/m(2)). Trends were similar across sex and different degrees of urbanisation, but varied across age groups. In 20-to 39-year-old women, mean BMI increased by 1.7 kg/m(2), which was more than in older age groups (P<or=0.05). With respect to LTPA, no clear trend was observed during 1990-1997 and 2001-2004. The (absence of) trends were similar across sex and urbanisation degrees, but varied across age groups. During 2001-2004, 20-to 39-year-old women spent approximately 150 min/week less on LTPA compared to older women, while this difference was smaller during 1990-1997.

CONCLUSIONS

Mean BMI increased more in younger women, which is consistent with the observation that this group spent less time on LTPA during recent years. Although the overall increase in overweight could not be explained by trends in LTPA, the younger women should be considered as a target group for future physical activity interventions. The influence of the 'obesogenic environment' seems to be similar across different degrees of urbanisation.

International Physical Activity Questionnaire

PURPOSE

This study was conducted to criterion-validate the short format of International Physical Activity Questionnaire (IPAQ) against health-related fitness.

METHODS

Participants included 951 men, aged 21-43 yr. VO2max by ergometer was used to measure cardiorespiratory fitness. Muscular fitness tests included the number of sit-ups, push-ups, and squats performed during 60 s. Physical activity was assessed from IPAQ by categories for health (health-enhancing physical activity (HEPA)) and by calculating total and vigorous MET-hours per week. The participants were classified in five groups of almost equal size by the IPAQ outcomes. Moreover, the frequency of vigorous activity was assessed by one precoded question (single-item question on leisure-time vigorous physical activity (SIVAQ)).

RESULTS

The mean fitness improved from the first through the fourth IPAQ group. VO2max in the most active IPAQ group, however, was lower than in the fourth group (P < 0.05), both with HEPA categories and vigorous METs as the outcome. In contrast, the weekly frequency of vigorous physical activity showed a positive association with fitness through all six categories. The 65 sedentary (according to SIVAQ) and unfit individuals who belonged to the highest 20% (by IPAQ total METs) were older (30.6 +/- 5.1 vs 28.9 +/- 3.8, P = 0.02), more obese (waist 93 +/- 12 vs 89 +/- 10 cm), more often current smokers (59.4 vs 42.0%; P = 0.03), and less educated (<12 yr of education 70.8 vs 52.0%; P = 0.02), compared with the others in the highest IPAQ group.

CONCLUSIONS

Almost 10% of young men had poor fitness and apparently low physical activity, but they reported very high physical activity by IPAQ. An evident need therefore exists to develop IPAQ further to solve the apparent overreporting by a considerable proportion of sedentary individuals.

A randomised control trial comparing lifestyle groups, individual counselling and written information in the management of weight and health outcomes over 12 months

OBJECTIVE

To investigate the effect of an 8-week group-based cognitive behaviour therapy lifestyle intervention with monthly follow-up to 6 months and further follow up at 12 months on change in weight and other weight-related variables, change in physical activity and change in health and well being compared to individualised dietetic treatment or giving an information booklet only (BO).

DESIGN

A randomised controlled trial of two intervention groups, a group-based cognitive behaviour therapy lifestyle intervention, Fat Booters Incorporated--(FBI) and individualised dietetic treatment (IDT) and control group receiving an information booklet only (BO). The intervention groups involved weekly contact for 8 weeks with monthly follow-up to 6 months and further follow-up at 12 months, conducted in real practice setting.

SUBJECTS

A total of 176 adults with body mass index (BMI)>27 kg/m2, mean (+/-s.d.) age 48+/-13 years, mean BMI 34+/-5.5 kg/m2.

MAIN OUTCOME MEASURES

Weight, percent body fat, waist circumference, physical activity, health status, self-efficacy and satisfaction with life were measured at baseline, 3, 6 and 12 months.

RESULTS

A statistically significant difference between groups was observed for weight change over time (P=0.05). The change in weight (mean+/-s.e.) for the FBI group was significantly greater than the BO group at 3 and 12 months (-2.8+/-0.7 compared to -1.0+/-0.6 kg, P<0.05 and -2.9+/-0.9 compared to +0.5+/-0.9 kg, P<0.005, respectively). Change in weight in the IDT group did not differ from the FBI group at any time point. For all groups, waist circumference was significantly less than baseline at all time points (P<0.001). Significant differences in self-efficacy were observed over time (P=0.02), with both intervention groups having greater self-efficacy than the BO group. Significant drop-outs occurred over time for all three groups.

CONCLUSIONS

A cognitive behaviour-based lifestyle intervention was more effective than providing an information booklet alone and as effective as intensive individualised dietetic intervention in weight loss and improvements in self-efficacy.

Comparison of two physical activity questionnaires in obese subjects: the NUGENOB study

PURPOSE

Simple instruments are needed to assess habitual physical activity (PA) in obese subjects. In a multicenter European obesity project, we tested whether PA assessments by two questionnaires were correlated and similarly associated to selected obesity-related variables.

METHODS

A total of 757 obese subjects (75% female; age 37.1 [7.9] yr, BMI 35.5 [4.9] kg.m(-2), mean [SD]) completed the Baecke questionnaire (assessing work, sport, and nonsport leisure activity) and the short last 7-d version of the International Physical Activity Questionnaire (IPAQ; assessing vigorous, moderate-intensity, walking activity, and sitting). We assessed percent body fat (bioimpedance), waist circumference, and fasting plasma concentrations of glucose, insulin, leptin, and FFA. Insulin sensitivity was assessed by the HOMA index for insulin resistance (HOMAIR).

RESULTS

Using the IPAQ, only about one third of men and women were classified as insufficiently active. Total habitual PA assessments by the Baecke and IPAQ were significantly related (Spearman rho = 0.51 in total sample, P < or = 0.0001, with adjustment for age, gender, and center). Using principal component analysis, we built two uncorrelated indices corresponding to general obesity (determined by high body fat and leptin) and abdominal obesity (determined by high waist circumference and HOMAIR). PA scores from both questionnaires were negatively related to general and abdominal obesity indices, except for abdominal obesity with the IPAQ in men.

CONCLUSIONS

Total PA assessments by the two questionnaires were found to correlate significantly, and the general pattern of associations of PA with general obesity was similar for the two questionnaires. However, the IPAQ may capture less of the relationships between PA and abdominal obesity than the Baecke, especially in men. Reporting of habitual PA in obese subjects with the IPAQ warrants further evaluation against objective assessment methods.

Physical activity policy and program development: the experience in Finland

This article describes the development of sports and physical activity policies and programs in Finland during the past 30 years. The past two decades have been marked by a shift in emphasis from competitive and elite sports to health-enhancing physical activity for all, as seen most clearly in two successive sports acts and a government resolution. The new, increasingly multisectoral policies have led to substantial changes in the public funding of sports organizations, services, and construction of sports sites. Furthermore, three successive five-year national physical activity promotion programs have been launched. As a result, increased and new types of opportunities to participate in physical activity have become available, and the infrastructure and networks for provision of services have been strengthened. Until the mid 1990s, leisure time physical activity increased in Finland, but during the last seven to eight years, both leisure time and commuting physical activity have been stable. This finding may be an indication of the difficulty to increase physical activity in an industrialized country with already relatively high levels of physical activity even when systematic, long-term policies and measures are applied.

Using different physical activity measurements in eight European countries. Results of the European Physical Activity Surveillance System (EUPASS) time series survey

OBJECTIVES

The European Physical Activity Surveillance System (EUPASS) research project compared several physical activity (PA) measures (including the International Physical Activity Questionnaire (IPAQ)) in a time series survey in eight countries of the European Union. The present paper describes first results provided by the different instruments regarding PA participation, frequency and duration, both at the European and national levels. The purpose of the present study is to explore and compare the specific quality and usefulness of different indicators rather than to provide valid and reliable prevalence data. Thus, the main focus is on discussion of the methodological implications of the results presented.

METHODS

A time series survey based on computer-aided telephone interviewing (CATI) was carried out in eight European countries over a six-month period. The study provided for about 100 realised interviews per month in each country (i.e. approximately 600 per country). Descriptive statistical analysis was used to: (1) report IPAQ results on vigorous, moderate and light PA and sitting, as well as on the overall measure of calories expenditure (MET min-1), in the different countries; (2) compare these results with national PA indicators tested in EUPASS; and (3) compare IPAQ results with other European studies.

RESULTS

First, the scores for the different PA categories as well as for the overall measure of calories expenditure provided by the IPAQ appeared rather high compared with previous studies and public health recommendations. Second, the different PA measurements used in EUPASS provided completely different results. For example, national indicators used in Germany and The Netherlands to date neither corresponded in absolute values (e.g. means of PA or sitting) nor correlated with the IPAQ in any significant way. Third, comparing EU countries, the ranking for vigorous, moderate and light activities by use of the IPAQ differed from that of other European studies. For example, in the present analysis, German respondents generally showed higher scores for PA than the Finns and the Dutch, while, in contrast, findings from other studies ranked Finland before The Netherlands and Germany.

CONCLUSIONS

The present analysis highlights some methodological implications of the IPAQ instrument. Among other things, differences in overall scores for PA as well as in the ranking of nations between the present results using IPAQ and other measures and studies may partly be due to the concepts of PA behind the measurements. Further analysis should investigate if the range of PA-related categories provided by the IPAQ is fully appropriate to measure all relevant daily activities; it may also consider the public health implications of mixing up different contexts of PA (e.g. work, leisure-time, transportation) in the IPAQ short version.