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A prospective study of the determinants of physical activity in rural fifth-grade children.

BACKGROUND: Understanding the factors that influence physical activity behavior is important in the design of intervention programs targeted at youth. METHODS: A prospective study design was used to identify the predictors of vigorous physical activity (VPA) (> or = 6 METs) and moderate and vigorous physical activity (MVPA) (> or = 3 METs) among 202 rural, predominantly African-American children. Selected social-cognitive determinants of physical activity were assessed via questionnaire in the fifth grade. Participation in VPA and MVPA was assessed via the previous day physical activity recall 1 year later in the sixth grade. RESULTS: For girls, participation in community sports, self-efficacy in overcoming barriers, enjoyment of school physical education, race (white > black), and perception of mother's activity level (active vs inactive) were significant predictors of VPA. For MVPA, participation in community sports and self-efficacy in overcoming barriers were significant predictors. For boys, self-efficacy in overcoming barriers was the only significant predictor of VPA, while beliefs regarding activity outcomes and participation in community sports were significant predictors of MVPA. CONCLUSION: Social-cognitive constructs such as physical activity self-efficacy, access to community physical activity outlets, and positive beliefs regarding physical activity outcomes are important predictors of future physical activity behavior among rural, predominantly African-American children.

Analysis of Variance↗

Correlates of changes in leisure time physical activity over 2 years: the Healthy Worker Project.

BACKGROUND: This study is the first to examine associations between concurrent changes in demongraphics, health behaviors, and physical activity in a free-living cohort of adults. METHODS: Surveys were conducted at 32 worksites (n = 3,672 workers) before and after a 2-year health promotion intervention. Associations between concurrent changes in sociodemographics, health, health behaviors, and physical activity were examined. Characteristics of individuals were also examined in four extreme physical activity change groupings: consistently very active, consistently very inactive, and changing from one extreme to the other over time. RESULTS: Among women, being married was associated with consistently low levels of physical activity, and increases in education were associated with increases in physical activity. Among both men and women, maintenance of single marital status was associated with increased physical activity levels, and increases in BMI were associated with decreases in physical activity. Increases in high-fat/calorie food intake were associated with increases in physical activity among men, but not among women. CONCLUSION: The observed associations indicate factors that may be important for understanding decreases in physical activity. The dynamic associations between changes in sociodemographics and physical activity demonstrate the need to examine changes in sociodemographics over time, rather than at only a single time point.

Adult↗

[Health promotion by sports and physical activity: politics, behavior and infrastructures in a European comparison].

OBJECTIVES: The focus of physical activity promotion is moving from measures to increase health-enhancing physical activity on the individual level to higher-level strategies including policy and environmental approaches. Scientific evidence, traditionally related to individual-based strategies, calls for adaptation and refinement when environmental and policy changes become more relevant. METHODS: This paper investigates differences in physical activity promotion and public policy among six European countries. Data from a European study on public health promotion policy and health behaviours (MAREPS) is analysed to study behaviour, community-based opportunities for physical activity, and populations' perception of the effectiveness of their national policies in promoting physical activity. RESULTS: Analyses show significant differences in both involvement in and perceived opportunities for physical activity among the investigated countries. Populations in Finland, Switzerland, and The Netherlands show comparably higher participation and, at the same time, perceive better opportunities for physical activity within the residential environment than people in East Germany, Belgium, and Spain. Moreover, respondents from the former group of nations report considerably greater contribution of health policy in their country to the promotion of physical activity than respondents from the latter group. CONCLUSIONS: In conclusion, the results provide empirical support for the significance of environmental and policy approaches with regard to physical activity. Opportunities created by implementing such approaches may enable populations to develop more active lifestyles conducive to health. Further research employing longitudinal designs could be especially helpful to explore the causalities of the relationship between policy, environment and physical activity.

Adolescent↗

Efficacy of an individualized, motivationally-tailored physical activity intervention.

This study compared the efficacy of two low-cost interventions for physical activity adoption. Sedentary (N = 194) adults recruited through newspaper advertisements were randomized to receive either a motivationally-matched, individually-tailored intervention (IT) or a standard self-help intervention (ST). Assessments and interventions were delivered by repeated mailings at baseline, one, three, and six months. Participants were assessed regarding current physical activity behavior, motivational readiness to adopt regular physical activity, and psychological constructs associated with physical activity participation (e.g. self-efficacy, decisional balance). Repeated measures analyses of variance (ANOVAs) revealed significant increases in physical activity participation between baseline and six months for both groups with a significantly greater increase among IT participants. The IT group outperformed the ST group on all primary outcome measures: (a) minutes of physical activity per week, (b) reaching Centers for Disease Control and American College of Sports Medicine (CDC/ACSM) recommended minimum physical activity criteria, and (c) achieving the Action stage of motivational readiness for physical activity adoption. Both groups showed significant improvement between baseline and six months on the psychological constructs associated with physical activity adoption (e.g. self-efficacy), with no significant differences observed between the treatment groups. Utilizing computer expert systems and self-help manuals to provide individually-tailored, motivationally-matched interventions appears to be an effective, low-cost approach for enhancing physical activity participation in the community.

Adult↗

Hip section modulus, a measure of bending resistance, is more strongly related to reported physical activity than BMD.

We hypothesized that measures of physical activity would have a closer relationship with section modulus (SM), an indicator of bending resistance, than with bone mineral density (BMD) because physical activity might expand the bony envelope, which tends to reduce BMD for a constant bone mineral content. Four hundred twenty-three men and 436 women (mean age 72 years, SD =3) were recruited from a prospective population-based cohort study to a study of hip bone loss. Hip BMD was measured on two occasions 2-5 years apart (mean 2.7, DXA-Hologic 1,000 W). Hip structural analysis (HSA) software was used to calculate SM and BMD from the DXA scans on three narrow regions: the narrow neck (NN), intertrochanter (IT) and shaft (S). A physical activity and lifestyle questionnaire was administered at baseline. Multivariate repeated measures analysis of variance was used to model the associations between personal attributes (weight, height, age), physical activity and lifestyle variables with SM, cross-sectional area (CSA), sub-periosteal diameter (PD) and BMD. Men and women were analysed together after tests for interactions with gender, which were found not to be significant. In all regions female gender was associated with having lower values of all outcomes, and body weight was positively associated with all outcomes, i.e., SM, CSA, PD and BMD ( P<0.0001). Sub-periosteal diameter was positively associated with reported lifetime physical activity (IT and S, P<0.0001). There was a significant decline of BMD with age at the NN and S regions ( P<0.026), and the PD increased with age (NN and S, P<0.019). Previous fracture history was associated with having lower values of BMD, SM and CSA (except for S; P<0.022). Both section modulus and CSA were positively associated with heavy physical activity after age 50 years in all regions ( P<0.019), whereas NN BMD was the only BMD associate of heavy physical activity after 50 ( P=0.036). Time spent per week on recreational activities classified as no impact activity was positively associated with BMD, CSA and SM (multivariate P<0.016). In conclusion, proximal femur diameter is associated positively with reported life-long physical activity. If this is mediated through a loading related effect on sub-periosteal expansion, BMD would be an unsatisfactory outcome measure in physical activity studies since it is inversely related to projected bone area. SM in contrast was associated with several measures of recent physical activity and relates more directly to the bending experienced by the proximal femur in response to a given load. These data are consistent with an effect of mechanical loading to regulate bone strength through an anabolic effect maximal in the subperiosteal cortex, where the highest loading-related strains are experienced.

Absorptiometry, Photon↗

Triggers of myocardial ischemia during daily life in patients with coronary artery disease: physical and mental activities, anger and smoking.

OBJECTIVES: This study assessed the potency of physical and mental activities and emotions (anger and anxiety) and smoking and other substance use as proximate triggers of ischemia in patients with coronary artery disease during daily life. BACKGROUND: Myocardial ischemia occurs during a wide variety of activities in patients with coronary artery disease, but frequency and relative potency of physical and mental activities, smoking and use of caffeine and alcohol as triggers of ischemia during daily life have not been established. METHODS: Patients (n = 63) with coronary artery disease and evidence of out-of-hospital ischemia kept a validated structured diary of physical and mental activities and psychologic states while undergoing ambulatory electrocardiographic monitoring for 24 to 48 h. RESULTS: Ischemia occurred most frequently during moderately intense physical and mental activities. Patients spent the largest proportion of time engaged in low intensity physical and mental activities (p < 0.05), but the likelihood of ischemia was greatest during intense physical (p < 0.0001) and stressful mental activities (p < 0.03). The percentage of time in ischemia was elevated and approximately equivalent for high intensity physical and high intensity mental activities (5%) compared with 0.2% when patients were engaged in low intensity activities. Strenuous physical activity (e.g., effortful walking, p < 0.05) and the experience of intense anger were potent ischemic triggers, and heart rates at onset of ischemia increased with the intensity of physical and mental activity and with anger. Among smokers, ischemia was more than five times as likely when patients smoked than when they did not (during 24% vs. 5% of diary entries, p < 0.0001). Coffee and alcohol consumption were also related to ischemia (p < 0.05), but this association disappeared after controlling for concurrent cigarette smoking. CONCLUSIONS: Triggers of ischemia in patients with coronary artery disease during daily life include not only strenuous exercise, but also activities involving low levels of exertion, such as anger and smoking. Mental activities appear to be as potent as physical activities in triggering daily life ischemia. Coffee and alcohol consumption are related to ischemia only by virtue of their associations with smoking.

Activities of Daily Living↗

Frequent and occasional physical activity in the elderly: a 12-year follow-up study of mortality.

BACKGROUND: The positive health effects of physical activity are well known. However, there are few studies of the association between different levels of physical activity and all-cause mortality among elderly people. METHODS: A national random sample of 3206 women and men aged >/=65 were interviewed in 1988 and 1989 and followed until December 31, 2000, for all-cause mortality. Cox regression was used to analyze the association between five different levels of physical activity and all-cause mortality, after adjustment for gender, age, education, smoking habits, body mass index, diabetes, hypertension, and self-rated health. All analyses were conducted in 2003. RESULTS: For elderly people who were physically active occasionally, the risk of all-cause mortality was 28% lower than for those who were physically inactive (hazard ratio [HR]=0.72; confidence interval [CI]=0.64-0.81), after adjustment for all explanatory variables. For those who were physically active once a week, the risk of all-cause mortality was 40% lower than for those who were physically inactive (HR=0.60; CI=0.50-0.71). For those who were physically active more frequently, the reduction in all-cause mortality risk was about the same as for those who were physically active once a week. Diabetes, hypertension, and daily smoking were, as expected, significant risk factors for all-cause mortality. CONCLUSIONS: Physical activity, even occasionally, decreases the risk of all-cause mortality among elderly people. Preventive resources among the elderly should include moderate exercise such as walking.

Aged↗

Physical activity promotion in primary care: bridging the gap between research and practice.

BACKGROUND: While a growing literature supports the effectiveness of physical activity interventions delivered in the primary care setting, few studies have evaluated efforts to increase physician counseling on physical activity during routine practice (i.e., outside the context of controlled research). This paper reports the results of a dissemination trial of a primary care-based physical activity counseling intervention conducted within the context of a larger, multi-strategy, Australian community-based, physical activity intervention, the 10,000 Steps Rockhampton Project. METHODS: All 23 general practices and 66 general practitioners (GPs, the Australian equivalent of family physicians) were invited to participate. Practice visits were made to consenting practices during which instruction in brief physical activity counseling was offered, along with physical activity promotion resources (print materials and pedometers). The evaluation, guided by the RE-AIM framework, included collection of process data, as well as pre- and post-intervention data from a mailed GP survey, and data from the larger project's random-digit-dialed, community-based, cross-sectional telephone survey that was conducted in Rockhampton and a comparison community. RESULTS: Ninety-one percent of practices were visited by 10,000 Steps staff and agreed to participate, with 58% of GPs present during the visits. General practitioner survey response rates were 67% (n =44/66 at baseline) and 71% (n =37/52, at 14-month follow-up). At follow-up, 62% had displayed the poster, 81% were using the brochures, and 70% had loaned pedometers to patients, although the number loaned was relatively small. No change was seen in GP self-report of the percentage of patients counseled on physical activity. However, data from the telephone surveys showed a 31% increase in the likelihood of recalling GP advice on physical activity in Rockhampton (95% confidence interval [CI]=1.11-1.54) compared to a 16% decrease (95% CI=0.68-1.04) in the comparison community. CONCLUSIONS: This dissemination study achieved high rates of GP uptake, reasonable levels of implementation, and a significant increase in the number of community residents counseled on physical activity. These results suggest that evidence-based primary care physical activity counseling protocols can be translated into routine practice, although the initial and ongoing investment of time to develop partnerships with relevant healthcare organizations, and the interest generated by the overall 10,000 Steps program should not be underestimated.

Attitude of Health Personnel↗

Linking objectively measured physical activity with objectively measured urban form: findings from SMARTRAQ.

BACKGROUND: To date, nearly all research on physical activity and the built environment is based on self-reported physical activity and perceived assessment of the built environment. OBJECTIVE: To assess how objectively measured levels of physical activity are related with objectively measured aspects of the physical environment around each participant's home while controlling for sociodemographic covariates. METHODS: Objective measures of the built environment unique to each household's physical location were developed within a geographic information system to assess land-use mix, residential density, and street connectivity. These measures were then combined into a walkability index. Accelerometers were deployed over a 2-day period to capture objective levels of physical activity in 357 adults. RESULTS: Measures of land-use mix, residential density, and intersection density were positively related with number of minutes of moderate physical activity per day. A combined walkability index of these urban form factors was significant (p =0.002) and explained additional variation in the number of minutes of moderate activity per day over sociodemographic covariates. Thirty-seven percent of individuals in the highest walkability index quartile met the > or =30 minutes of physical activity recommended, compared to only 18% of individuals in the lowest walkability quartile. Individuals in the highest walkability quartile were 2.4 times more likely (confidence interval=1.18-4.88) than individuals in the lowest walkability quartile to meet the recommended > or =30 minutes of moderate physical activity per day. CONCLUSIONS: This research supports the hypothesis that community design is significantly associated with moderate levels of physical activity. These results support the rationale for the development of policy that promotes increased levels of land-use mix, street connectivity, and residential density as interventions that can have lasting public health benefits.

Adult↗

Physical activity from childhood to adulthood: a 21-year tracking study.

BACKGROUND: The aim of this study was to investigate stability of physical activity from childhood and adolescence to adulthood in multiple age cohorts, and analyze how well adult physical activity can be predicted by various physical activity variables measured in childhood and adolescence. METHODS: The data were drawn from the Cardiovascular Risk in Young Finns Study. The study was started in 1980, when cohorts of randomly sampled boys and girls aged 3, 6, 9, 12, 15, and 18 years (total of 2309 subjects) were examined for the first time. The measurements were repeated in 1983, 1986, 1989, 1992, and 2001. In 2001, the subjects (n =1563, 68%) were aged 24, 27, 30, 33, 36, and 39 years, respectively. Physical activity was measured by means of a short self-report questionnaire that was administered individually in connection with a medical examination. On the basis of a questionnaire, a physical activity index (PAI) was calculated. There were no significant differences in the 1980 PAI between participants and dropouts in 2001. RESULTS: Spearmans rank order correlation coefficients for the 21-year tracking period varied from 0.33 to 0.44 in males, and from 0.14 to 0.26 in females. At shorter time intervals the correlation was higher. On average, the tracking correlation was lower in females than in males. Persistent physical activity, defined as a score in the most active third of the PAI in two or three consecutive measurements, increased the odds that an individual would be active in adulthood. Odds ratios for 3-year continuous activity versus continuous inactivity varied from 4.30 to 7.10 in males and 2.90 to 5.60 in females. The corresponding odds ratios for 6-year persistence were 8.70 to 10.80 and 5.90 to 9.40. CONCLUSIONS: It was concluded that a high level of physical activity at ages 9 to 18, especially when continuous, significantly predicted a high level of adult physical activity. Although the correlations were low or moderate, we consider it important that school-age physical activity appears to influence adult physical activity, and through it, the public health of the general population.

Adolescent↗

Intimate partner violence and women's physical, mental, and social functioning.

OBJECTIVE: To describe the relationship between women's health and the timing, type, and duration of intimate partner violence (IPV) exposure. METHODS: A telephone interview was completed by 3429 women aged 18 to 64 randomly selected from a large health plan, to assess IPV exposure and heath status (response rate 56.4%). Questions from the Behavioral Risk Factor Surveillance System and the Women's Experience with Battering scale were used to construct IPV exposures: (1) recent (past 5 years) and remote (before past 5 years only) IPV exposure of any type (physical, sexual, or non-physical); (2) recent (past 5 years) IPV exposure to physical and/or sexual or non-physical only; and (3) IPV duration (0 to 2 years, 3 to 10 years, and >10 years). Health outcomes were measured using the Short Form-36 survey (SF-36), the Center for Epidemiologic Studies Depression scale, and the National Institute of Mental Health Presence of Symptoms survey. RESULTS: In adjusted models, compared to women with no IPV in their adult lifetime, more-pronounced adverse health effects were observed for women with recent (vs remote) IPV; for physical and/or sexual (vs non-physical) IPV; and for longer IPV exposure. Compared to women who never experienced IPV, women with any recent IPV (physical, sexual, or non-physical) had higher rates of severe (prevalence ratio [PR]=2.6; 95% confidence interval [CI]=1.9-3.6) and minor depressive symptoms (PR=2.3; 95% CI=1.9-2.8); higher number of physical symptoms (mean, 1.0; 95% CI=0.7-1.2); and lower SF-36 mental and social functioning scores (range, 4.3-5.5 points lower across subscales). Women with recent physical and/or sexual IPV were 2.8 times as likely to report fair/poor health, and had SF-36 scores that ranged from 5.3 to 7.8 points lower, increased risk of depressive symptoms (PR=2.6) and severe depressive symptoms (PR=4.0), and more than one additional symptom. Longer duration of IPV was associated with incrementally worse health. CONCLUSIONS: Women's health was adversely affected by the proximity, type, and duration of IPV exposure.

Adolescent↗

Evaluation of a national physical activity intervention for children: VERB campaign, 2002-2004.

BACKGROUND: Amid concern for the consequences of physical inactivity among children, the Centers for Disease Control and Prevention started a campaign using commercial marketing methods to promote physical activity to children. DESIGN: Longitudinal study using a telephone survey to assess physical activity behaviors and attitudes at baseline and for 2 years of follow-up. Relationships of campaign awareness to behavioral and psychosocial effects were analyzed with use of propensity scoring. PARTICIPANTS: Nationally representative cohort of 2257 parent-child dyads. INTERVENTION: Marketing campaign (VERB) directed to all U.S. children aged 9 to 13 years. Components included general market and ethnic-specific advertisements on television and radio, in print, and through promotions in communities, schools, and on the Internet. Advertising ran nationally at consistent levels from June 2002 through June 2004. MAIN OUTCOME MEASURES: Psychosocial measures and self-reports of free-time and organized physical activity during nonschool hours in the week before the interview and on the day before the interview. RESULTS: After 2 years, a dose-response effect was detected in the study population. The more children who reported seeing VERB messages, the more physical activity they reported and the more positive their attitudes were about the benefits of being physically active. Children aware of VERB reported engaging in significantly more physical activity than children unaware of VERB. These results were considerably stronger than the effects after Year 1, which were only for physical activity among subpopulations. CONCLUSIONS: The VERB campaign continued to positively influence children's attitudes about physical activity and their physical activity behaviors and expanded the effects to more children. With adequate and sustained investment, health marketing shows promise to affect the attitudes and behavior of children.

Adolescent↗

Maternal use of physical punishment in response to child misbehavior: implications for child abuse prevention.

OBJECTIVE: The objective was to examine the roles of cognition and affect in maternal use of physical punishment. METHOD: Through a review of the literature, distal and proximal predictors (cognitive and affective) of physical punishment use were identified. One hundred and ten mothers of 3-year-old children were interviewed regarding two disciplinary situations that occurred during the previous 2-week period that elicited their strongest reactions: one which resulted in the use of physical punishment (if this occurred) and one which did not. The individual and combined contributions of the predictors of physical punishment use were analyzed through logistic regression. RESULTS: The predictors of physical punishment following individual analyses were: maternal attitude toward physical punishment, maternal perception of the seriousness and intent of the child misbehavior, and maternal anger in response to the child misbehavior. Through multivariate analysis 54% of the variance in physical punishment use was explained. CONCLUSIONS: Both cognitive and affective factors affect the decision to use physical punishment with children. These findings can be useful in establishing parenting educational programming that is directed at decreasing the rates of physical punishment and subsequently child physical abuse.

Adoption↗

Physical activity, exercise coping, and depression in a 10-year cohort study of depressed patients.

BACKGROUND: Epidemiological research examining the relationship between physical activity and depression has been conducted almost exclusively with community samples. We examined associations between physical activity, exercise coping, and depression in a sample of initially depressed patients, using four waves of data spanning 10 years. METHODS: A cohort (n=424) of depressed adults completed measures of physical activity, exercise coping, depression, and other demographic and psychosocial constructs at baseline, 1-year, 4-years, and 10-years, with a 90% wave-to-wave retention rate. Multilevel modeling was used to analyze individual depression trajectories. RESULTS: More physical activity was associated with less concurrent depression, even after controlling for gender, age, medical problems, and negative life events. Physical activity counteracted the effects of medical conditions and negative life events on depression. However, physical activity was not associated with subsequent depression. The findings for exercise coping were comparable. LIMITATIONS: Measures of physical activity and exercise coping encompassed a limited set of activities and did not include information about duration or intensity. CONCLUSION: Our results suggest that more physical activity is associated with reduced concurrent depression. In addition, it appears that physical activity may be especially helpful in the context of medical problems and major life stressors. Clinically, encouraging depressed patients to engage in physical activity is likely to have potential benefits with few obvious risks.

Adaptation, Psychological↗

Acculturation and physical activity among North Carolina Latina immigrants.

The objective of this study was to examine the association between acculturation and physical activity among first generation Latina (Hispanic women) immigrants living in North Carolina. As part of the multi-site Women's Cardiovascular Health Network, 671 first generation Latina immigrants 20-50 years of age completed in-person interviews on physical activity, acculturation (measured by a language scale, length of residence in the US, and age at arrival in the US) and other potential individual and contextual correlates of physical activity. All statistical models were adjusted for age, general health, number of children in the home, marital status, and education, with self-reported physical activity as the dependent variable. Among participants, 37.4% met recommendations for physical activity, 41.9% reported insufficient activity, and 20.7% reported no moderate or vigorous activity. Latinas with higher English language acculturation were more likely to be physically active than women with lower English language acculturation. Likewise, women who arrived to the US when they were younger than 25 years were more likely to be physically active than women who arrived when they were 25 years or older. Length of residence in the US was not associated with physical activity. These relationships persisted when restricting the sample to Mexican born women. We conclude that among first generation immigrants living in North Carolina, those with higher English language acculturation or who arrived to the US at younger ages were more likely to report being physically active. These findings suggest that future epidemiologic studies and physical activity interventions should measure and tailor programs based on English-language use and age of arrival to the US among Latina immigrants.

Acculturation↗

Correlates of physical activity in a national sample of children aged 9-13 years.

BACKGROUND: Physical activity (PA) is critical for children's normal growth and development. The purpose of this study was to assess potential correlates of physical activity in a US national sample of youth aged 9-13 years. METHODS: A nationally representative telephone survey of parent-child pairs was conducted from April through June 2002. The questions assessed organized and free-time physical activity behavior and psychosocial and environmental variables that are potentially related to youth physical activity. RESULTS: Children's positive outcome expectations or beliefs about the benefits of participating in physical activity and parent's beliefs that participating in physical activity is important were related to participation in both organized and free-time physical activity. Children's perception of parental support and parent's reports of direct support were strongly related to organized physical activity. Feeling safe, having lots of places to be active, and parental participation with their child were strongly related to free-time physical activity. CONCLUSIONS: Messages and interventions aiming to increase children and adolescent's participation in organized and free-time physical activity should continue to focus on promoting the benefits that are associated with being active, the importance of parental support, and the provision of safe and enjoyable opportunities to be active.

Adolescent↗

Influence of leisure time physical activity and television watching on atherosclerosis risk factors in the NHLBI Family Heart Study.

Physical activity favorably influences atherosclerosis risk factors but only a few studies in adults considered the time watching television (TV) as a measure of physical inactivity. We therefore determined in a population-based sample of 1778 subjects from the NHLBI Family Heart Study (FHS) whether leisure time physical activity and TV watching have independent or interactive associations with cardiovascular disease risk factors and carotid artery intima-media wall thickness (IMT). Subjects were free from diabetes mellitus and clinically-ascertained coronary artery disease and did not take lipid-lowering or antihypertensive drugs. Only 0.7 and 1.3% of the variance in leisure time physical activity in women and men, respectively, was explained by the amount of TV watching. Leisure time physical activity had a clearly favorable, and TV watching an unfavorable association with anthropometric measurements (BMI (body mass index), waist girth, waist-hip ratio, subscapular and triceps skinfold thickness). The odds ratio (95% CI) of being overweight was 0.41 (0.28-0.62) in women and 0.69 (0.46-1.04) in men in the highest quartile of leisure time physical activity compared to the lowest quartile. The odds ratio increased for increasing quartiles of TV watching to 2.12 (1.45-3.10) in women and 1.61 (1.07-2.43) in men. Watching TV only 1 h per day in women with a BMI of 30 kg/m2 and doing about 75 min of moderate exercise per week was associated with a BMI 1.8 kg/m2 lower than in women watching TV 3 h per day and doing the same amount of exercise. Those with twice the amount of moderate exercise and watching TV 1 h per day had a BMI 0.45 kg/m2 lower. Furthermore, leisure time physical activity was negatively associated with concentrations of triglycerides and positively with HDL cholesterol in both genders. TV watching was significantly positively associated with triglycerides and slightly negatively with HDL cholesterol in men. The observed associations of leisure time physical activity and TV watching with atherosclerosis risk factors were independent from each other. Finally, we analyzed the relation between leisure time physical activity, TV watching and the degree of IMT of the carotid arteries. Neither of these two measures was significantly associated with IMT. In summary, TV watching, in addition to leisure time physical activity, shows an independent association with obesity-related anthropometric measurements, HDL and triglycerides. Decreasing the amount of TV watching might be effective as a first step in reducing atherosclerosis risk factors, especially overweight.

Adult↗

Associations between recommended levels of physical activity and health-related quality of life. Findings from the 2001 Behavioral Risk Factor Surveillance System (BRFSS) survey.

BACKGROUND: Although the benefits of regular physical activity on morbidity and mortality are established, relationships between recommended levels of physical activity and health-related quality of life (HRQOL) have not been described. The authors examined whether recommended levels of physical activity were associated with better HRQOL and perceived health status. METHODS: Using data from 175,850 adults who participated in the 2001 Behavioral Risk Factor Surveillance System survey, the authors examined the independent relationship between recommended levels of moderate or vigorous physical activity and four measures of HRQOL developed by the U.S. Centers for Disease Control and Prevention. Multivariate logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for age, race/ethnicity, sex, education, smoking status, and body mass index. RESULTS: The proportion of adults reporting 14 or more unhealthy days (physical or mental) was significantly lower among those who attained recommended levels of physical activity than physically inactive adults for all age, racial/ethnic, and sex groups. After multivariate adjustment, the relative odds of 14 or more unhealthy days (physical or mental) in those with the recommended level of activity compared to physically inactive adults was 0.67 (95% CI: 0.60, 0.74) for adults aged 18-44 years, 0.40 (95% CI: 0.36, 0.45) for adults aged 45-64 years, and 0.41 (95% CI: 0.36, 0.46) for adults aged 65 years or older. The results persist even among adults with a chronic condition such as arthritis. CONCLUSIONS: These results highlight the need for health programs to increase participation in regular physical activity.

Activities of Daily Living↗