Changes in leisure time and occupational physical activity over 8 years: the Cornelle Health Interview Survey Follow-Up Study

Criterion validity of the Saltin-Grimby Physical Activity Level Scale in adolescents. The Fit Futures Study

Background

The Saltin-Grimby Physical Activity Level Scale (SGPALS) is commonly used to measure physical activity (PA) in population studies, but its validity in adolescents is unknown. This study aimed to assess the criterion validity of the SGPALS against accelerometry in a large sample of adolescents. A secondary aim was to examine the validity across strata of sex, body mass index (BMI), parental educational level, study program and self-reported health.

Methods

The study is based on data from 572 adolescents aged 15–17 years who participated in the Fit Futures Study 2010–11 in Northern Norway. The participants were invited to wear an accelerometer (GT3X) attached to their hip for seven consecutive days. We used Spearman’s rho and linear regression models to assess the validity of the SGPALS against the following accelerometry estimates of PA; mean counts/minute (CPM), steps/day, and minutes/day of moderate-to-vigorous physical activity (MVPA).

Results

The SGPALS correlated with mean CPM (ρ = 0.40, p<0.01), steps/day (ρ = 0.35, p<0.01) and MVPA min/day (ρ = 0.35, p<0.01). We observed no differences between correlations within demographic strata (all p>0.001). Higher scores on SGPALS were associated with a higher CPM, higher number of steps per day and more minutes of MVPA per day, with the following mean differences in PA measurements between the SGPALS ranks: CPM increased by 53 counts (95% CI: 44 to 62), steps/day increased by 925 steps (95% CI: 731 to 1118), and MVPA by 8.4 min/day (95% CI: 6.7 to 10.0). Mean difference between the highest and lowest SGPALS category was 2947 steps/day (6509 vs. 9456 steps/day) and 26.4 min/day MVPA (35.2 minutes vs 61.6 minutes).

Conclusion

We found satisfactory ranking validity of SGPALS measured against accelerometry in adolescents, which was fairly stable across strata of sex, BMI, and education. However, the validity of SGPALS in providing information on absolute physical activity levels seem limited.

Occupational physical activity trends from 1987 to 2017: A nationally representative sample of 160,509 Spanish adults

AIMS

To estimate temporal and updated trends of OPA among Spanish adult population during the period between 1987 and 2017.

METHODS

We used all available rounds of the Spanish National Health Survey (160,509 adults, mean age 44.6 years [SD 16.6], 50.3% women) and multivariate regressions to determine temporal trends of high OPA from 1987 to 2017 in the general working population of Spain.

RESULTS

The highest OPA prevalence was observed for participants aged 31-49 years in the 2003 survey. The prevalence of high OPA was generally low, but increased slightly over time in the 18-30, 50-64, and 65-75 years old (p<0.001 for trend). In contrast, a general reduction in OPA was observed in the 16-17 years old (p<0.001 for trend). Men consistently showed higher OPA prevalence than women.

CONCLUSIONS

This study reports an increase in OPA prevalence in Spain from 1987 to 2017, which is low and significant in most socio-demographic groups, but small in absolute terms. The youngest group had a marked decreased in OPA prevalence over the course of the study. Men consistently showed higher OPA prevalence than women, but differences have become smaller in recent years. Our results may assist in the establishment of interventional strategies and future policies among specific subgroups.Highlights: There is an increase in OPA prevalence in Spain from 1987 to 2017.The youngest group had a marked decreased in OPA prevalence over the course of the study.Men consistently showed higher OPA prevalence than women, but differences have become smaller in recent years.Frequent national surveillance of OPA to monitor long-term development of the working environment should be mandatory.

Physical activity and sedentary behaviour over adulthood in relation to all-cause and cause-specific mortality: a systematic review of analytic strategies and study findings

BACKGROUND

Questions remain about the effect on mortality of physical activity and sedentary behaviour over time. We summarized the evidence from studies that assessed exposure from multiple time points and critiqued the analytic approaches used.

METHODS

A search was performed on MEDLINE, Embase, Emcare, Scopus and Web of Science up to January 2021 for studies of repeatedly assessed physical activity or sedentary behaviour in relation to all-cause or cause-specific mortality. Relative risks from individual studies were extracted. Each study was assessed for risk of bias from multiple domains.

RESULTS

We identified 64 eligible studies (57 on physical activity, 6 on sedentary behaviour, 1 on both). Cox regression with a time-fixed exposure history (n = 45) or time-varying covariates (n = 13) were the most frequently used methods. Only four studies used g-methods, which are designed to adjust for time-varying confounding. Risk of bias arose primarily from inadequate adjustment for time-varying confounders, participant selection, exposure classification and changes from measured exposure. Despite heterogeneity in methods, most studies found that being consistently or increasingly active over adulthood was associated with lower all-cause and cardiovascular-disease mortality compared with being always inactive. Few studies examined physical-activity changes and cancer mortality or effects of sedentary-behaviour changes on mortality outcomes.

CONCLUSIONS

Accumulating more evidence using longitudinal data while addressing the methodological challenges would provide greater insight into the health effects of initiating or maintaining a more active and less sedentary lifestyle.

Do declines in occupational physical activity contribute to population gains in body mass index? Tromsø Study 1974-2016

OBJECTIVE

To examine whether occupational physical activity changes predict future body mass index (BMI) changes.

METHODS

This longitudinal cohort study included adult participants attending ≥3 consecutive Tromsø Study surveys (examinations 1, 2 and 3) from 1974 to 2016 (N=11 308). If a participant attended >3 surveys, the three most recent surveys were included. Occupational physical activity change (assessed by the Saltin-Grimby Physical Activity Level Scale) was computed from the first to the second examination, categorised into persistently inactive (n=3692), persistently active (n=5560), active to inactive (n=741) and inactive to active (n=1315). BMI change was calculated from the second to the third examination (height being fixed at the second examination) and regressed on preceding occupational physical activity changes using analysis of covariance adjusted for sex, birth year, smoking, education and BMI at examination 2.

RESULTS

Overall, BMI increased by 0.84 kg/m2 (95% CI 0.82 to 0.89). Following adjustments as described previously, we observed no differences in BMI increase between the occupational physical activity change groups (Persistently Inactive: 0.81 kg/m2, 95% CI 0.75 to 0.87; Persistently Active: 0.87 kg/m2, 95% CI 0.82 to 0.92; Active to Inactive: 0.81 kg/m2, 95% CI 0.67 to 0.94; Inactive to Active: 0.91 kg/m2, 95% CI 0.81 to 1.01; p=0.25).

CONCLUSION

We observed no prospective association between occupational physical activity changes and subsequent BMI changes. Our findings do not support the hypothesis that occupational physical activity declines contributed to population BMI gains over the past decades. Public health initiatives aimed at weight gain prevention may have greater success if focusing on other aspects than occupational physical activity.

Socioeconomic status and change in sports activity among middle-aged and older men and women: evidence from the German Ageing Survey

BACKGROUND

Sports activity (SA) behavior is unequally distributed across socioeconomic status (SES) groups. However, little is known about the impact of SES on change in SA over time.

METHODS

Based on data from the German Ageing Survey, we examined the role of objective (education, occupational prestige, household equivalent income, composite SES-index) and subjective (self-rated standard of living) SES indicators on negative and positive changes in SA during a follow-up of 6 years among adults aged 40+ years using logistic regression analysis.

RESULTS

Among active individuals at baseline, 32.1% of males and 24.8% of females experienced a negative change in SA. Among inactive individuals, 25.8 and 29.9% experienced a positive change. In the multivariate analysis, males and females with low SES were about twice as likely to experience a negative change and half as likely to experience a positive change. These patterns were observed regardless which SES indicator was examined.

CONCLUSIONS

This study provides comprehensive evidence for socioeconomic inequalities in negative and positive changes in SA behavior among middle-aged and older adults in Germany. To reduce socioeconomic inequalities, future SA interventions should address the mechanisms leading to differential probabilities of change in SA behavior by SES.

Trends and Correlates of High-Risk Alcohol Consumption and Types of Alcoholic Beverages in Middle-Aged Korean Adults: Results From the HEXA-G Study

Background

We aimed to report the prevalence and correlates of high-risk alcohol consumption and types of alcoholic beverages.

Methods

The baseline data of the Health Examinees-Gem (HEXA-G) study participants, including 43,927 men and 85,897 women enrolled from 2005 through 2013, were used for analysis. Joinpoint regression was performed to estimate trends in the age-standardized prevalence of alcohol consumption. Associations of demographic and behavioral factors, perceived health-related effects, social relationships, and the diagnostic history of diseases with alcohol consumption were assessed using multinomial logistic regression.

Results

The prevalence of alcohol consumption remained higher in men during the study period and increased in women. The amount of alcohol consumed has increased in women, especially that from beer and makgeolli, a traditional Korean fermented rice wine. Older participants were less likely to be high-risk drinkers (men and women who drink more than 40 or 20 g/day of alcohol, respectively) and drink Soju, a distilled liquor, and beer, and more likely to drink makgeolli. Educational level was negatively associated with high-risk drinking. However, it was positively associated with the consumption of strong spirits and wine. Smoking was associated with high-risk drinking and the consumption of soju and strong spirits. Engaging in regular exercise and having stress were associated with drinking all types of beverages except for soju.

Conclusions

Sex-specific trends in alcohol consumption were influenced by demographic, behavioral, and perceived health-related factors. The findings will help improve the understanding of alcohol-related problems and provide evidence for establishing country-specific policies and campaigns in Korea.

Why are adult women physically active? A systematic review of prospective cohort studies to identify intrapersonal, social environmental and physical environmental determinants

OBJECTIVE

This study aims to systematically review available evidence from prospective cohort studies to identify intrapersonal, social environmental and physical environmental determinants of moderate-to-vigorous intensity physical activity (MVPA) among working-age women.

METHODS

Six databases were searched to identify all prospective cohort studies that reported on intrapersonal (e.g. self-efficacy and socioeconomic status [SES]), social (e.g. crime, area SES and social support) and/or physical (e.g. weather, work and recreation) environmental determinants of MVPA in working-age (mean 18-65 years) women. A qualitative synthesis including harvest plots was completed.

PROSPERO

CRD42014009750 RESULTS: Searching identified 17,387 potential articles; 97 were used in the analysis. The majority (n = 87 studies) reported on ≥1 intrapersonal determinant. Very few (n = 34) examined factors in the social or physical environments, and none looked at social policy. Positive and consistent influencers included higher self-efficacy (n = 18/23), self-rated health (n = 8/13) and intentions (n = 10/11) and perceived behavioural control (n = 5/7) to be physically active. Having children in the household was negatively related to MVPA (n = 9/15).

CONCLUSIONS

Physical activity intervention studies should consider a woman's level of self-efficacy and perceived behavioural control to be physically active. Additional studies are needed on the impact of children in the household, having a spouse/partner and using group goal setting. More evidence is needed to evaluate the impact of environmental factors.

Association between education and future leisure-time physical inactivity: a study of Finnish twins over a 35-year follow-up

Background

Education is associated with health related lifestyle choices including leisure-time physical inactivity. However, the longitudinal associations between education and inactivity merit further studies. We investigated the association between education and leisure-time physical inactivity over a 35-year follow-up with four time points controlling for multiple covariates including familial confounding.

Methods

This study of the population-based Finnish Twin Cohort consisted of 5254 twin individuals born in 1945–1957 (59 % women), of which 1604 were complete same-sexed twin pairs. Data on leisure-time physical activity and multiple covariates was available from four surveys conducted in 1975, 1981, 1990 and 2011 (response rates 72 to 89 %). The association between years of education and leisure-time physical inactivity (<1.5 metabolic equivalent hours/day) was first analysed for each survey. Then, the role of education was investigated for 15-year and 35-year inactivity periods in the longitudinal analyses. The co-twin control design was used to analyse the potential familial confounding of the effects. All analyses were conducted with and without multiple covariates. Odds Ratios (OR) with 95 % Confidence Intervals (CI) were calculated using logistic and conditional (fixed-effects) regression models.

Results

Each additional year of education was associated with less inactivity (OR 0.94 to 0.95, 95 % CI 0.92, 0.99) in the cross-sectional age- and sex-adjusted analyses. The associations of education with inactivity in the 15- and 35-year follow-ups showed a similar trend: OR 0.97 (95 % CI 0.93, 1.00) and OR 0.94 (95 % CI 0.91, 0.98), respectively. In all co-twin control analyses, each year of higher education was associated with a reduced likelihood of inactivity suggesting direct effect (i.e. independent from familial confounding) of education on inactivity. However, the point estimates were lower than in the individual-level analyses. Adjustment for multiple covariates did not change these associations.

Conclusions

Higher education is associated with lower odds of leisure-time physical inactivity during the three-decade follow-up. The association was found after adjusting for several confounders, including familial factors. Hence, the results point to the conclusion that education has an independent role in the development of long-term physical inactivity and tailored efforts to promote physical activity among lower educated people would be needed throughout adulthood.

[Domains of physical activity and education in São Paulo, Brazil: a serial cross-sectional study in 2003 and 2008]

This study aimed to estimate the prevalence of physical activity in different domains and the association with schooling, using a serial cross-sectional population-based design comparing data from two editions of a health survey in the city of São Paulo, Brazil. Participation included 1,667 adults in 2003 and 2,086 in 2008. Probabilistic sampling was performed by two-stage clusters. The long version of International Physical Activity Questionnaire (IPAQ) allowed evaluating multiple domains of physical activity. Poisson regression was used. Men were more active in their leisure time and at work and women in the home. Schooling was associated directly with leisure-time activity (2003 and 2008) and inversely with work-related physical activity (2003) for men and for women in housework. The studies showed that Brazilians with less schooling are becoming less active, so that intervention strategies should consider different educational levels. Interventions in the urban space and transportation can increase the opportunities for physical activity and broaden access by the population.

Predictors of physical activity change among adults using observational designs

BACKGROUND

Regular physical activity (PA) is foundational to human health, yet most people are inactive. A sound understanding of the determinants of PA may be instructive for building interventions and/or identifying critical target groups to promote PA. Most research on PA correlates has been biased by cross-sectional or passive prospective designs that fail to examine within-person analysis of PA change.

OBJECTIVE

The purpose of this review was to collect and appraise the available literature on the predictors of PA change conceived broadly in terms of increases/decreases from baseline assessment as well as specifically in terms of adoption and maintenance.

METHODS

Eligible studies were from English, peer-reviewed published articles that examined predictors of natural change of PA over 3 months + using observational (non-experimental) data in adult samples. Searches were performed from June 2012 to January 2014 in eight databases.

RESULTS

Sixty-seven independent data-sets, from 12 countries, primarily of medium quality/risk of bias, were identified with 26 correlates spanning demographic, behavioral, intra-individual, inter-individual, and environmental categories. Only intention and the onset of motherhood could reliably predict overall PA change. Among datasets configured to predict PA adoption, affective judgments and behavioral processes of change were the only reliable predictors, although both only have a small number of available studies. There were no reliable predictors of maintenance when compared to PA relapse.

CONCLUSION

The results underscore the importance of individual-level motivation and behavioral regulation in PA change, but also denote critical social variables. These findings, however, are constrained by PA measurement bias and limited studies that employed time-varying covariation between predictor variables and PA.

Leisure time physical activity in a 22-year follow-up among Finnish adults

BACKGROUND

The aim of this study was to explore long-term predictors of leisure time physical activity in the general population.

METHODS

This study comprised 718 men and women who participated in the national Mini-Finland Health Survey from 1978-1980 and were re-examined in 2001. Participants were aged 30-80 at baseline. Measurements included interviews, health examinations, and self-administered questionnaires, with information on socioeconomic position, occupational and leisure time physical activity, physical fitness, body mass index, smoking, alcohol consumption, and physical functional capacity. Analyses included persons who were working and had no limitations in functional capacity at baseline.

RESULTS

The strongest predictor of being physically active at the follow-up was participation in physical activity at baseline, with an OR 13.82 (95%CI 5.50-34.70) for 3 or more types of regular activity, OR 2.33 (95%CI 1.22-4.47) for 1-2 types of regular activity, and OR 3.26 (95%CI 2.07-5.15) for irregular activity, as compared to no activity. Other determinants for being physically active were moving upwards in occupational status, a high level of baseline occupational physical activity and remaining healthy weight during the follow-up.

CONCLUSIONS

To prevent physical inactivity among older adults, it is important to promote physical activity already in young adulthood and in middle age and to emphasize the importance of participating in many types of physical activity.

Trends in leisure time and work-related physical activity in the Spanish working population, 1987-2006

OBJECTIVE

To analyze time trends in the prevalence of leisure time (LTPA) and work-related (WRPA) physical activity between 1987 and 2006 in the Spanish working population.

METHODS

We analyzed data taken from the Spanish National Health Surveys for 1987 (n = 29,647), 1993 (n = 20,707), 1995-1997 (n = 12,800), 2001 (n = 21,058), 2003 (n = 21,650), and 2006 (n = 29,478). The main variables were LTPA and WRPA in working adults aged 18-64 years old. We analyzed sociodemographic characteristics, self-perceived health status, lifestyle habits and associated comorbidities using multivariate logistic regression models.

RESULTS

The prevalences of LTPA and WRPA were lower in women than in men (p < 0.05). The practice of LTPA (OR: 1.54, 95%CI: 1.32-1.80 for women; OR = 1.15, 95%CI: 1.02-1.31 for men) and WRPA (OR = 1.73, 95%CI: 1.38-2.19 for women; OR = 1.55, 95%CI: 1.44-1.91 for men) significantly increased from 1987 to 2006. In both genders, the variables associated with a higher likelihood of practicing LTPA were greater age, higher educational level and being an ex- or non-smoker, while negative predictors included being married, worse self-perceived health, and obesity. Factors that increased the probability of reporting WRPA were being married, worse self-rated health status, and sleeping > 8h per day. The only factor that reduced the probability of reporting WRPA was being an ex- or non-smoker.

CONCLUSIONS

We found an increase in LTPA and WRPA in the last 20 years in the Spanish working population. Several factors were associated with a higher or lower likelihood of practicing LTPA or WRPA in this population.

Time trends in leisure time physical activity and physical fitness in elderly people: 20 year follow-up of the Spanish population national health survey (1987-2006)

BACKGROUND

To estimate trends in leisure time physical activity and physical fitness between 1987-2006 in older Spanish people.

METHODS

We analyzed data collected from the Spanish National Health Surveys conducted in 1987 (n = 29,647), 1993 (n = 20,707), 1995-1997 (n = 12,800), 2001 (n = 21,058), 2003 (n = 21,650), and 2006 (n = 29,478). The number of subjects aged ≥ 65 years included in the current study was 29,263 (1987: n = 4,958-16.7%; 1993: n = 3,751-17.8%; 1995-97: n = 2,229-17.4%; 2001: n = 4,356-20.7%; 2003: 6,134-28.3%; 2006: 7,835-26.5%). Main variables included leisure-time physical activity and physical fitness. We analyzed socio-demographic characteristics, self-rated health status, lifestyle habit and co-morbid conditions using multivariate logistic regression models.

RESULTS

Women exhibited lower prevalence of leisure time physical activity and physical fitness compared to men (P < 0.05). The multivariate analysis for time trends found that practising leisure time physical activity increased from 1987 to 2006 (P < 0.001). Variables associated with a lower likelihood of practicing leisure time physical activity were: age ≥ 80 years old, ≥ 2 co-morbid chronic conditions, and obesity. Variables associated with lower physical fitness included: age ≥ 80 years, worse self rated health; ≥ 2 medications (only for walking), and obesity.

CONCLUSIONS

We found an increase in leisure time physical activity in the older Spanish population. Older age, married status, co-morbid conditions, obesity, and worse self-perceived health status were associated with lower activity. Identification of these factors can help to identify individuals at risk for physical inactivity.

Incidence of overweight and obesity in a Mediterranean population-based cohort: the Cornellà Health Interview Survey Follow-up Study (CHIS.FU)

OBJECTIVE

To study the changes in body mass index (BMI) in a population-based cohort and their relationship with sociodemographic variables in a Mediterranean-country.

METHOD

A prospective population-based cohort with 8-year follow-up. The data used derive from the Cornellà-Health-Interview Survey Follow-up (CHIS.FU). 1008 people aged > or = 20 years (females=508; males=500) were interviewed in 1994 and in 2002, providing self-reported weight and height data. The BMI was compared using the Wilcoxon test for paired data. Changes in the BMI were calculated and their relationship with sociodemographic-variables and lifestyles using multivariate Breslow-Cox regression.

RESULTS

28.1% of participants had changed from normal-BMI in 1994 to overweight in 2002 (women=25.6%; men=31.6%). 16.8% increased from overweight to obesity (women=25.8%; men=11.2%). The cumulative incidence of overweight: women=26.4%; men=34.0%. The cumulative incidence of obesity: women=29.9%; men=13.1%. The cumulative age and sex-adjusted incidence of overweight showed a significant relationship with marital-status (married: RR=2.0; 95% CI: 1.2-3.4, divorced/widowed: RR=4.0; 95% CI: 1.7-9.3) and moderate alcohol-consumption (RR=1.86; 95% CI: 1.1-3.1). We observed a decreased age-adjusted risk in the incidence of obesity for men (RR=0.49; 95% CI: 0.3-0.8).

CONCLUSION

The observed changes in the increase in the incidence of obesity and overweight indicated a similar evolution in the obesity epidemic regardless of Mediterranean dietary patterns in our population.