Journal of Physical Activity and Health

Published by Human Kinetics
Online ISSN: 1543-5474
Publications
Article
Little is known about the sociodemographics and lifestyle behaviors of ultramarathon runners, and the effects of these characteristics on body weight and body mass index (BMI). We cross-sectionally analyzed baseline data of 1,212 ultramarathoners on sociodemographics, lifestyle behaviors and BMI from the initial 12-month enrollment period in a longitudinal observational study. The ultramarathoners were mostly middle-aged men who were more educated, more likely to be in a stable relationship, and more likely to use over-the-counter vitamins/supplements than the general population. They appear to gain less body weight with advancing age than the general population. Factors with the greatest effect on current BMI were BMI at 25 years of age and sex which explained 48% and 3% of the variance. Negligible, but statistically significant direct relationships, with BMI were observed for age, work hours per week, television watching hours per week, and composite fat consumption frequency score. Negligible, but statistically significant inverse relationships, with BMI were observed for running distance during the prior year, and composite fruit and vegetable consumption frequency score. While lifestyle decisions were found to impact BMI within this group of ultramarathoners, BMI at age 25 was the strongest predictor of current BMI.
 
Article
To determine whether individuals participating in a program designed to accumulate 10,000 steps/ day demonstrate health, fitness and psychological benefits. Sedentary individuals (22 F, 7 M; age 59.8 +/- 5.78 yr) were randomly assigned into a walking (W, n = 14) or control (C, n = 15) group. Following baseline assessment, the W group was given a daily plan to reach 10,000 steps/day within 3 weeks and asked to maintain this level for 12 weeks; the C group was asked to maintain their current activity. Participants were evaluated for cardiovascular endurance, resting and postexercise HR, functional ability, cholesterol, psychological well-being, and exercise self-efficacy before and following the 15-week program. Significant changes over time were noted between groups (G x T; P < .05) with the W group demonstrating improvements in postexercise HR (-6.51%), total cholesterol (TC: -7.74%), and personal growth (2.53%). While not statistically significant, the W group also demonstrated improvements in 6 min walk distance (2.32%), total/HDL ratio (-10.09%), 8 foot up-and-go time (-3.35%), chair stands (6.17%), flexibility (128%), and environmental mastery (4.54%). A 15-week program aimed at accumulating 10,000 steps/day improves cardiovascular performance and personal growth and also positively influences many variables that are indicators of health, fitness and psychological well-being.
 
Article
With more than 1.1 million high school athletes playing annually during the 2005-06 to 2009-10 academic years, football is the most popular boys' sport in the United States. Using an internet-based data collection tool, RIO, certified athletic trainers (ATs) from 100 nationally representative US high schools reported athletic exposure and football injury data during the 2005-06 to 2009-10 academic years. Participating ATs reported 10,100 football injuries corresponding to an estimated 2,739,187 football-related injuries nationally. The injury rate was 4.08 per 1000 athlete-exposures (AEs) overall. Offensive lineman collectively (center, offensive guard, offensive tackle) sustained 18.3% of all injuries. Running backs (16.3%) sustained more injuries than any other position followed by linebackers (14.9%) and wide receivers (11.9%). The leading mechanism of injury was player-player contact (64.0%) followed by player-surface contact (13.4%). More specifically, injury occurred most commonly when players were being tackled (24.4%) and tackling (21.8%). Patterns of football injuries vary by position. Identifying such differences is important to drive development of evidence-based, targeted injury prevention efforts.
 
— Flowchart showing the timeline of events of pedometer program and study.  
Components of the Metabolic Syndrome Before and After the 12-Week Pedometer Program 
— Weekly increases in steps/day over baseline for the active group during the 12-week program  
— Scatterplot showing the relationship between improvements in steps/day and change-scores of self-report PA as measured by the Stanford Usual Activity Questionnaire (SUAQ) in the active group (r = .463, P < .01).  
Article
Pedometer programs can increase physical activity in sedentary individuals, a population that is at risk for developing metabolic syndrome and each of its individual components. Although the popular 10,000 steps/day recommendation has shown to induce many favorable health benefits, it may be out of reach for sedentary individuals. This study observed the effects of incremental increases in steps/day on metabolic syndrome components in sedentary overweight women. This study was a longitudinal, quasi-experimental design. Participants were recruited from a 12-week work-site pedometer program and grouped as either 'active' or 'control' after the intervention based on their steps/day improvement. Self-reported physical activity, pedometer assessed physical activity, BMI, resting heart rate, waist circumference, blood pressure, triglycerides, HDL-C, and fasting glucose were measured before and after the program. The active group showed significant within-group improvements in waist circumference and fasting glucose. Significant group differences were observed in resting heart rate, BMI, and systolic blood pressure; however, the changes observed in systolic blood pressure were not independent of weight loss. Incremental increases in steps/day induced favorable changes in some MetS components suggesting that this approach is a viable starting point for sedentary individuals that may find it difficult to initially accumulate 10,000 steps/day.
 
Article
Recent public health initiatives have promoted accumulating 10,000 steps per day. Little previous research has evaluated its effects in young adults. The aim of this study was to determine the effects of taking 10,000 steps per day on fitness and cardiovascular risk factors in sedentary university students. Healthy, sedentary students (mean age 21.16 ± SD 6.17) were randomly allocated to take 10,000 steps per day or to a control group who maintained their habitual activity. Members of the 10,000 step group wore a pedometer and reported daily step count in a diary. Outcome measurements (20-meter multistage shuttle run, BMI, and blood pressure) were measured before and after 6 weeks. There were no significant differences between the groups at baseline. After 6 weeks, the 10,000 steps group were taking significantly more steps (8824.1 ± SD 5379.3 vs. 12635.9 ± SD 6851.3; P = .03).No changes were observed in fitness, or BMI (P > .05). Significant reductions in blood pressure (P = .04) in the 10,000 step group. A daily target of 10,000 steps may be an appropriate intervention in sedentary university students to increase their physical activity levels. The positive health benefits of simple everyday physical activity should be promoted among health professionals.
 
Article
Objective measures, such as accelerometers, are increasingly being used to measure physical activity (PA) levels in children, and the use of validated and reliable instruments is desirable when measuring the effectiveness of programs. The purpose of this study was to determine the validity and reliability of the New Lifestyles NL-1000 accelerometer among preschoolers using a modified version of the Children's Activity Rating Scale (CARS). Fourteen preschoolers wore the NL-1000 at their waist while the device measured activity levels [in seconds of moderate-to-vigorous physical activity (MVPA)]. They were also videoed for approximately 12 minutes while participating in normal activities at an early childhood center. At approximately 2-minute intervals, activity level readings derived from the NL-1000 were recorded. The video footage was analyzed using a modified CARS technique and the CARS scores compared with data obtained from the accelerometer. Within subject reliability was measured using intraclass correlation coefficients (0.58 for CARS and 0.59 for NL-1000). Furthermore, 95% of the variation in CARS could be explained by variation in the accelerometer counts, with 2.4% of the variation being participant-specific. The NL-1000 is a sufficiently reliable and valid tool for assessing MVPA in preschoolers.
 
Article
Evidence of an association between employment and physical activity (PA) in youth has been mixed, with studies suggesting both positive and negative associations. We examined the association between employment and PA among U.S. high school students as measured by self-reported overall PA, vigorous exercise, and participation in school athletic teams. We employed a secondary analysis using weighted linear regression to a sample of black and white 10th grade (n = 12073) and 12th grade students (n = 5500) drawn from the nationally representative cross-sectional 2004 Monitoring the Future Study. Overall, 36.5% of 10th and 74.6% of 12th grade students were employed. In multivariable analyses, 10th graders working >10 hours a week reported less overall PA and exercise and those working >20 hours a week reported less participation in team sports. Among 12th graders, any level of employment was associated with lower rates of team sports; those working >10 hours a week reported less overall PA; and those working >20 hours reported less exercise. Employment at and above 10 hours per week is negatively associated with PA. Increasing work intensity may shed light on the decline of PA as adolescents grow older and merits further attention in research.
 
Description of the Sample: The 1993 Pelotas (Brazil) Birth Cohort Study 
Article
Aim: To evaluate the longitudinal association between physical activity behavior at 11 years of age and the incidence of mental health problems from 11 to 15 years of age. Methods: Individuals born in the city of Pelotas, Brazil, in 1993 have been followed up since birth. At 11 and 15 years of age, mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ). At 11 years of age, physical activity was assessed through a validated questionnaire. The continuous SDQ score at 15 years was used as the outcome variable. The main exposure was physical activity behavior at 11 years of age divided into 3 categories (0, 1-299, ≥ 300 min/wk). Results: The incidence of mental health problems from 11 to 15 years was 13.6% (95% CI, 12.4-14.9). At 11 years, 35.2% of the adolescents achieved 300 min/wk of physical activity. In the unadjusted analysis, physical activity was inversely related to mental health problems (P = .04). After adjustment for confounders, the association was no longer significant in the whole sample but was still significant among boys. Conclusion: Physical activity appears to be inversely related to mental health problems in adolescence, but the magnitude of the association is weak to moderate.
 
— Mean steps/day and standard deviations for girls and boys by ethnicity. 
General Characteristics of Participating Schools
— Mean steps/day and standard deviations for girls and boys by metro status. *Significantly different from suburban girls at P < .001. 
Description of Participants and Data Obtained from Each School
— Mean steps/day and standard deviations by gender, ethnicity, and metro status. Note: Mean steps/day values were not reported for rural African American girls and boys and urban Caucasian girls and boys because of limited participants. 
Article
The purpose of this study was to conduct a secondary analysis by combining 2 pedometer data sets to describe and analyze pedometer-determined steps/day of children by ethnicity and metropolitan status. Participants were 582 children (309 girls, 273 boys; 53% Hispanic, 26% Caucasian, 21% African American) age 10 to 11 years (M = 10.37 +/- 0.48) attending 1 of 10 schools located in urban, suburban, and rural settings. Participants wore a research grade pedometer for at least 3 week/school days. Mean steps/day were analyzed by gender, ethnicity, and metropolitan status. Statistical analyses indicated 1) boys (12,853 +/- 3831; P < .001) obtained significantly more steps/day than girls (10,409 +/- 3136); 2) African American (10,709 +/- 3386; P < .05) children accumulated significantly less steps/day than Hispanic (11,845 +/- 3901) and Caucasian (11,668 +/- 3369) children; and 3) urban (10,856 +/- 3706; P < .05) children obtained significantly less steps/day than suburban (12,297 +/- 3616) and rural (11,934 +/- 3374) children. Findings support self-report data demonstrating reduced physical activity among African American children and youth, especially girls, and among children and youth living in urban areas. Possible reasons for these discrepancies are explored.
 
Descriptive Statistics for Each of the Subscales 
Means and Standard Deviations of the Subscales for Each of the Independent Variables 
Article
The aim of this study was to examine the relationship between physical activity and wellbeing in children, and to further explore the extent to which this may vary by gender and weight status. A representative sample of 1424 9- to 11-year-olds completed a self-report measure of physical activity, the Child Health and Illness Profile, KIDSCREEN, and a self-esteem scale. Body Mass Index (BMI) measurements were also obtained. 24% of children achieved the recommended level of 60 minutes of moderate-to-vigorous intensity physical activity (MVPA) per day, with more boys than girls achieving this level. Children achieving the recommended level of MVPA scored significantly higher on measures of the Child Health and Illness Profile (F(5, 1354) = 5.03; P < .001), KIDSCREEN (F(3, 1298) = 4.68; P = .003), and self-esteem (F(1, 1271) = 18.73; P = .003) than less active children although the effect sizes were small (ηp2 ≈ .01). Substantial gender differences in wellbeing were found reflecting gender specific behaviors and socialization. Weight status had negligible influence on wellbeing. Children who meet the recommended guidelines of MVPA were more likely to have better wellbeing. When attempting to raise children's physical activity levels consideration should be given to the specific relationships between wellbeing and physical activity.
 
Article
Few studies have compared physical activity (PA) and sedentary activity (SA) by grade and ethnicity, specifically including elementary school students. A cross-sectional probability-based design was used to provide data by ethnicity (African American, Hispanic, and White/Other), gender, and grade (4th, 8th, and 11th) from 2000 to 2002. Two validated questionnaires (elementary and secondary) assessed self-reported PA and SA. Point-prevalence estimates and 95% confidence intervals were computed. Over 70% of students reported vigorous PA on > or = 3 days/week, but < 50% participated in daily physical education. A significant percentage (30% to 50%) of students reported > or = 3 hours per day in SA. Fourth-grade boys and girls reported equal PA; however, 8th and 11th grade girls reported lowered vigorous PA. African American 8th- and 11th-grade boys reported the highest PA, but African American children also reported the highest prevalence of SA. Findings from this study highlight the disparities in physical and sedentary activities by gender, grade, and race/ethnicity, and the need to address these differences with programs and policy. In general, grade level and gender differences were more striking and consistent than racial/ethnic differences.
 
Article
Physical activity levels of girls decline in adolescence, but little is known about changes in participation in specific types of physical activity. This study examined change in participation in specific activities during adolescence in girls. Girls (N = 398, age 13.6 +/- 0.6 y at baseline, 58.5% African American) from 31 middle and 24 high schools in South Carolina completed the 3-Day Physical Activity Recall (3DPAR) in 8th, 9th, and 12th grades. Girls reported their predominant activity and its intensity level in each 30-min time block on the previous 3 d. Vigorous physical activity declined from 45.4% in 8th grade to 34.1% in 12th grade. The probability of participating in several forms of vigorous physical activity in 12th grade was strongly associated with participation in those activities in 8th grade. Early-in-life participation in sports and other forms of vigorous physical activity are important to the maintenance of physical activity during adolescence in girls.
 
Article
Declining levels of children's physical activity may contribute to Australia's increasing childhood obesity epidemic. School recess is an underutilized opportunity to increase children's physical activity. Thirteen regional Australian public primary schools participated in the study (2946 children). The Children's Activity Scanning Tool 2 (CAST2) collected observational playground physical activity data. The research also addressed: length of break, socioeconomic status (SES), gender, number of scanning days, and instrument calibration. The proportions of Moderate or Vigorous Physically Activity (MVPA) children at the observed schools ranged from 0.4 to 0.7. The odds ratio of boys being MVPA relative to girls ranged from 0.8581 to 2.137. There were significant differences between the mean proportions of 3 days of activity (range P = .001 to P = .015) and no association between SES school groupings (deviance ratio: 0.48; P = .503). Interrater reliability for instrument calibration using Spearman correlations coefficients ranged from r = .71 to r = .99. There were significant differences between proportions of MVPA children at the 13 schools and between male and female populations. There was no association between playground physical activity and SES. The monitoring period for CAST2 should be at least 3 days. Interrater reliability indicates that correlations between observers were consistently high.
 
Article
Sport has high social valence and is a primary context for physical activity for the majority of youth. The aim of this study was to estimate the contribution of participation in organized sport to the total daily energy expenditure and also to its moderate-to-vigorous portion in male adolescents. The sample comprised 165 Portuguese male youth, aged 13 to 16 years. Physical activity was assessed with a multi-method approach (Actigraph GT1M accelerometer plus 3-day diary record). Differences in the intensities of physical activity and sedentary behavior of male sport participants and nonsport participants were compared using independent sample t-test. Male participants in organized sports spent significantly more time in moderate-to-vigorous activities than nonparticipants, although the P-value for the 15 to 16 years age-group was marginal (P = .08) on the weekend days. In addition, male adolescents spent 11% to 13% of total daily energy expenditure in organized sports which corresponded to 35% to 42% of the moderate-to-vigorous portion of daily energy expenditure. Organized sport appears to be a relevant component of daily activity energy expenditure to promote healthy lifestyles among male adolescents.
 
Article
Low physical activity has been associated with increased fatness and deceased fitness. This observational study aimed to describe the magnitude, composition, and time-distribution of moderate-to-vigorous physical activity (MVPA) in Australian children. A total of 1132 10 to 13 year old schoolchildren completed a 24-h activity recall diary on 2 to 4 occasions. MVPA was defined as any activity requiring ≥3METs, including sport, play, active transport, chores, and other activities. MVPA was higher in boys than girls (173 vs 140 min/day; P<.0001), higher on nonschool days than school days (166 vs 143 min/day; P<.0001), and decreased with age (9 min/day per year of age). MVPA consisted of structured sport (37%), active transport (26%), unstructured play (24%), and chores/miscellaneous activities (13%). Every hour of MVPA was associated with a reduction in screen time (26.5 min), non-screen-based sedentary pastimes (8 min), and sleep (5.5 min). The least active quartile of children were more likely to be girls (OR=3.4), have higher screen time, and sleep more. From 4:00-6:30 PM on school days there were large differences in participation between high-active and low-active children. Findings suggest MVPA interventions should target girls, screen time and focus on the after-school period.
 
Article
We examined trends of physical activity and screen time among nationally representative samples of children aged 9-13 years to explore whether children overall are becoming less physically active and less likely to be in compliance with screen time recommendations. We analyzed Youth Media Campaign Longitudinal Survey data for trends and demographic patterns of free time and organized physical activity, and hours and minutes of watching television and playing video or computer games. Child-parent dyads for 2002 (N = 3114), 2004 (N = 5177), and 2006 (N = 1200) were analyzed. On the day before the interview, and for free time physical activity in the past week, children reported a significant increase in physical activity from 2002-2006. Screen time levels were stable overall; 76.4% of children met the recommendations of 2 hours or less of daily screen time. Levels of physical activity among U.S. children aged 9-13 years were stable, or levels slightly improved from 2002-2006. Except for some subgroup differences, trends for compliance with screen time recommendations were also stable from 2002-2006 for U.S. children aged 9-13 years.
 
Article
to investigate levels of physical activity (PA) and sedentary behavior (SB) in 10-14 year-olds and to determine PA differences between week-weekend days, genders and school stages. 241 children were recruited from 15 primary and 15 secondary schools. PA was assessed for 7 days using the SenseWear Mini Armband and an electronic diary. Week-weekend and gender differences were determined using 2-way repeated-measures ANOVA. Combined intensity- and domain-specific PA differences between genders and school stages were examined using 2-way ANOVA. Weekdays were more active compared to weekend days. Physical activity level (PAL) of boys was higher compared with girls. Boys showed more moderate (+15 min/day) and vigorous PA (+9 min/day), no differences were found for SB and light PA. Secondary school children showed more SB (+111 min/day), moderate (+8 min/day) and vigorous (+9 min/day) PA and less light PA (-66 min/day) compared with primary school children. No difference was found for PAL. The results of the combined intensity- and domain-specific parameters revealed more nuanced differences between genders and school stages. Our results demonstrate the complexity of PA and SB behavior of children, indicating the need for a multidimensional and differentiated approach in PA promotion.
 
Physical Characteristics by Gender and Maturity Status
Unadjusted and Adjusted Models Displaying the Mean (SE) Minutes of MVPA for Each Maturity Group by Gender
Article
This study compared physical activity levels among early, average, and late maturing boys and girls. Physical activity was assessed with an Actigraph accelerometer in 161 (76 boys, 85 girls) 9 to 14 year olds over 7 consecutive days. Anthropometric variables were measured and the maturity offset (ie, years from peak height velocity) was predicted. Biological maturity groups (early, average, and late) were created based on the mean estimated age at peak height velocity for boys and girls separately. Levels of moderate-to-vigorous physical activity (MVPA) were similar between early, average, and late maturing boys and girls after adjusting for differences in chronological age. Levels of MVPA progressively declined across chronological age in boys and girls (P < .001) and gender differences existed at 10-, 12-, and 13-years, with boys having higher levels than girls (P < .05). When aligned according to biological age, gender-related differences in MVPA did not exist. Within this sample of 9 to 14 year old boys and girls, there were no significant differences in MVPA among early, average, and late maturing individuals.
 
Article
Researchers have noted both the utility and limitations of using pedometers to measure physical activity (PA). While these unobtrusive devices are widely accepted for their ability to measure accumulated PA, they have been criticized for their inability to measure exercise intensity. However, recent steps-per-minute (SPM) research provides reasonably accurate measures of intensity allowing users to assess time spent at recommended PA levels. Therefore, the purpose of this study was to determine the SPM taken that are associated with moderate physical activity in 12- to 14-year-old youth. Ninety-three participants (49 boys and 44 girls; ages 12 to 14) walked on a treadmill for 3 minutes at each of 4 different speeds while wearing a pedometer and a heart rate monitor. On average boys and girls reached their moderate activity intensity threshold at 122 SPM and 102 SPM, respectively. However, individual differences must be taken into account when determining appropriate SPM intensities for youth. The impact of individual differences underscores the need to address SPM for moderate intensity individually rather than with a single guideline for everyone at this age.
 
Article
A 16-week lunchtime walking intervention was designed to increase physical activity in physically inactive University employees. The programme was delivered and monitored twice over seven months to examine feasibility across different seasons. Seventy-five participants (n= 69 females, n= 6 males; M age = 47.68) were randomly allocated into a Winter (February start) or Spring group (May start). Participants were asked to complete three weekday lunchtime walks and two weekend walks. Weeks 1-10 were led by walk leaders (group phase) while the participants self-organized their walks during weeks 11-16 (independent phase). Yamax pedometers recorded daily step counts and walk group leaders recorded participant attendance in the group phase. Acceptability was assessed via a satisfaction survey and two focus groups with participants. A participant pool representative by ethnicity, but not gender was recruited using a range of strategies. The program demonstrated good retention across both groups (73%). The intervention was acceptable to participants. More steps were accumulated in the group-led versus the independent phase. The intervention is feasible in this workplace setting across different seasonal periods. In the future, researchers should examine if the findings can be replicated in a definitive trial and generalize to other workplace settings.
 
Characteristics of the Sample (Mean ± SD) 
Article
Different approaches to measuring physical activity and fatness in youth have resulted in studies reporting relationships ranging from very strong to nonexistent. The sample comprised 787 boys and 752 girls between the ages of 7 and 16 years. Pedometer-determined physical activity, height, weight, and waist girth measures were taken. Significant differences were found in activity level between body mass index-determined weight categories for the girls (F1,742 = 9.07, P = .003) but not for the boys (F1,777 = 3.59, P = .06) and between truncal adiposity groupings for the boys (F1,777 = 4.69, P = .03) and the girls (F1,742 = 13.56, P = .000). The relationship between physical activity and body fatness differs according to the measure used and between boys and girls. Factors contributing to body fatness such as eating behaviors or sedentary activities might be more important among boys than girls.
 
Article
A study deriving a threshold for moderate- to vigorous-intensity physical activity (MVPA) in terms of accelerometer counts in 12-year-old children was repeated with a subset of the same children at 16 years. Fifteen girls and thirty boys took part in 6 activities (lying, sitting, slow walking, walking, hopscotch and jogging) while wearing an Actigraph 7164 accelerometer and a Cosmed K4b2 portable metabolic unit. Random intercepts modeling was used to estimate cut points for MVPA (defined as 4 METs). Using a single model, the sex-specific thresholds derived for MVPA at 16 years were some way below the 3600 counts/minute used for both sexes at age 12, particularly for girls. However graphical examination suggested that a single model might be inadequate to describe both higher- and lower-intensity activities. Models using only lower-intensity activities close to the 4 METs threshold supported retention of the 3600 counts/minute cut point for both sexes. When restricting to lower-intensity activities only, these data do not provide sufficient evidence to change the previously established cut point of 3600 counts/minute to represent MVPA. However, further data and more sophisticated modeling techniques are required to confirm this decision.
 
Article
Background: Despite the benefits of physical activity, many Canadian adolescents are inactive and rates of inactivity increase with age. Few studies describe the pattern of change in physical activity as a function of age during adolescence. Methods: Data were drawn from the Nicotine Dependence in Teens Study. The analytic sample included 1206 adolescents who completed a 7-day physical activity recall up to 4 times per year over 5 years. Individual growth models, analyzed using multilevel models for change, were developed separately by sex controlling for season. Results: Physical activity levels through adolescence were best described by a cubic function. Levels increased from age 12 to a peak at approximately age 13.5, decreased to age 16.5, and increased again to age 17. Activity participation was highest in the spring and lowest during fall and winter. Substantial within- and between-subject heterogeneity in the trajectories was evident. Conclusion: Adolescent physical activity follows a complex, curvilinear pattern in both males and females, with considerable variation within- and between-persons.
 
— Mean sport score and 95% confidence intervals (95%) by age and sex. 
Prevalence (%) and Absolute Frequencies (in Parens) of Sport Participation by Age Group and Sex
Relative Distribution of the Most Popular Sports by Age and Sex
Relative Frequencies of the Amount of Time of Sports Participation
Article
The present study considered age- and sex-associated variation in sports participation (SP) in Portuguese youth. A national 12,568 students, 10-18 years, was surveyed. Two items of the Baecke et al. (1982) questionnaire that deal with SP were considered. Logistic regression and factorial ANOVA were used. The prevalence of SP is greater in males than females. Mean sport scores increased in both sexes from 10-18 years. Soccer was the most practiced sport among males, while swimming and soccer were the most practiced sports among females. Males participated in SP > 4 hours per week compared to 1-2 hours per week in females. High intensity sports were more prevalent among males, while sports of mid-level intensity were more prevalent among females. The majority of youth participate in sport more than 9 months of the year. SP is an important component of physical activity among Portuguese youth and has a relatively stable prevalence between 10-18 years.
 
Article
Leisure-time physical activity (LTPA) during pregnancy has maternal benefits, but effects on offspring have not often been considered. This study aimed to determine associations among trimester-specific LTPA during pregnancy and toddler size. Women (n = 300) were recruited while pregnant in 2006. At follow-up (2008), women reported demographics; recalled type, duration, and frequency of trimester-specific LTPA (MET·min/wk); and rated their toddler's current LTPA level (more, same, or less than others their age). A subset (n = 23) volunteered to have maternal and toddler height, weight, and body fat measured. Maternal body mass index (BMI) and toddler weight-for-height z-scores (WHZ) were calculated. Median toddler WHZ was 0.6 (range -0.5 to 2.9). In Spearman correlations, third trimester LTPA was marginally associated with lower toddler weight (rs = -0.39, P = .06) and WHZ (rs = -0.40, P = .06), but no other measures of maternal LTPA and toddler body size were related. Birth weight z-score was positively associated with toddler weight (rs = 0.51, P = .01) but negatively associated with percent body fat (rs= -0.46, P = .03). Measures of maternal size were unassociated with toddler size. These results provide preliminary support for LTPA during late pregnancy to have a lasting effect on offspring size.
 
Association between metabolic risk score and anxiety score in high and low physical activity groups. Solid line and circles represent the high physical activity group. Dashed line and triangles represent the low physical activity group. 
Partial Correlations, Controlling for Age and Maturity Offset, Between Selected Measures of Stress and the Metabolic Risk Score in Male Adolescents 
Article
We examined whether physical activity modifies the relationship between stress and the metabolic risk score in 8- to 18-year-old males (n = 37). Physical activity (PA) and television (TV)/videogame (VG) use were assessed via accelerometer and questionnaire, respectively. Stress was determined from self-report measures. A metabolic risk score (MRS) was created by summing age-standardized residuals for waist circumference, mean arterial pressure, glycosylated hemoglobin, and high-density lipoprotein cholesterol. Correlations between PA and MRS were low (r < -.13), and TV and VG were moderately associated with MRS (r = .39 and .43, respectively). Correlations between stress-related variables and MRS ranged from r = .19 to .64. After partitioning by PA, significant correlations were observed in the low PA group between school- and sports-related self-esteem and anxiety with the MRS. The results provide suggestive evidence that PA might modify the relationship between stress and MRS in male adolescents.
 
Article
This report describes changes in the percentage of US students (age 5 to 18 years) who walked or bicycled to school and in the distance that they lived from or traveled to their school in 1969 and 2001 and travel patterns in 2001. Data were from the 1969 National Personal Transportation Survey report on school travel and the 2001 National Household Transportation Survey. A smaller percentage of students lived within 1 mile of school in 2001 than in 1969. The percentage of students who walked or biked any distance decreased from 42.0% to 16.2%. Nearly half of students used more than 1 travel mode or went to an additional destination en route between home and school in 2001. Multidisciplinary efforts are needed to increase the percentage of students who walk or bike to school, as well as decrease the distances that students travel.
 
Article
The objective was to describe the patterns and mechanisms of water tubing-related injuries treated in U.S. emergency departments. The National Electronic Injury Surveillance System was used to examine cases of water tubing-related injuries. Sample weights were used to calculate national estimates of water tubing-related injuries. Analyses were conducted in 2010. From 1991-2009 an estimated 69,471 injuries were treated in US emergency departments for water tubing-related injuries. The annual number of cases increased 250% over the 19-year study period (P < .001). Sprains and strains accounted for the largest portion of injuries (27.2%). The head was the most frequently injured body part (27.5%). Children and adolescents ≤ 19 years were more likely to be injured by contact with another person (OR: 2.47; 95% CI = 1.61-3.80) and were more likely to sustain injuries to the head (OR: 2.61; 95% CI = 2.01-3.38) compared with adults. Adults ≥ 20 years, were more likely than individuals ≤ 19 years to sustain sprains and strains (OR: 2.11; 95% CI = 1.64-2.71) and were most commonly injured by impact with the water (54.6%). Patterns of water tubing-related injuries differ for children and adults. Research is needed to determine how best to reduce these injuries.
 
— Number of dance-related injuries by year treated in US emergency departments, 1991–2007. 
Body Part, Body Region, and Diagnosis of Dance-Related Injuries by Age Group Treated in US Emergency Departments, 1991-2007
Article
Background: Dancing is one of the most physically strenuous activities on the musculoskeletal system. As other literature has previously described, the types, sites, and rates of dance-related injuries are similar to those suffered by athletes in traditional sports. Methods: A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System from 1991-2007. Sample weights were used to calculate national estimates of dance-related injuries. Trend significance of the numbers and age-adjusted rates of dance-related injuries over time was analyzed using linear regression. Results: An estimated 113,084 children and adolescents 3-19 years of age were treated in US emergency departments for dance-related injuries. Classical dance (ballet, jazz, tap, modern) accounted for 55.0% of dance-related injuries. Adolescents 15-19 years of age constituted 40.4% of the dance-related injury cases. The majority of injuries (58.1%) occurred to the lower extremities. Sprains or strains were the most common injury (52.4%) and falls were the most common mechanism of injury (44.8%). Conclusions: Dance-related injuries have distinct injury patterns and mechanisms of injury. Injury patterns differ by types of dance and by age. Further research is needed to identify injury prevention strategies specific to these age groups.
 
Article
Prospective studies on physical activity (PA), diet, and body composition in adolescents are lacking, particularly outside high-income countries. To describe the methods used to assess these variables in the 1993 Pelotas (Brazil) Birth Cohort and to discuss the fieldwork challenges faced and alternatives to overcome them. In 2006-07 a subsample of the 1993 Pelotas cohort was revisited. PA was estimated using questionnaires, a combined heart-rate and motion sensor (Acti-Heart), and the ActiGraph GT1M accelerometer. Diet was investigated by questionnaire. Total body water was determined by stable isotopes. Thirty individuals had their total energy expenditure assessed by doubly labeled water. All data were collected at participants' home. The logistics of the fieldwork and the difficulties in undertaking the study and alternatives to overcome them are presented. Preliminary analyses show that 511 individuals were traced (response rate = 90.0%). Compliance of both adolescents and their families for the motion sensors and body-composition measurements was excellent. The authors conclude that it is feasible to carry out high-quality studies on PA in developing countries. They hope the article will be useful to other researchers interested in carrying out similar studies.
 
— The proportions of fitness/fatness groups by gender and race/ethnicity. Note. The bars represent the proportions of the fitness/fatness groups within a race/ethnicity group and 95% confidence intervals. The numbers in the legend present the proportions in each race/ethnicity group (95% confidence intervals) among 1670 boys and 1595 girls. * Significantly different from White (P < .05).  
— Age-and race/ethnicity-adjusted means of cardiovascular risk factors among boys. Note. The first 2 bars represent age-and race/ethnicity-adjusted means and 95% confidence intervals of the 'fit' and 'not fit' groups. The last 4 bars represent age-, race/ethnicity-, and waist circumference-adjusted means and 95% confidence intervals of the 'fit' and 'not fit' groups within the 'not fat' and 'fat' groups. * Six cardiovascular risk factors were significantly different between the 'fit' and 'not fit' groups (P < .05). † After adjustment for fatness, only total cholesterol, triglyceride, insulin, and CRP levels were significantly different between the 'fit' and 'not fit' groups (P < .05). CRP = C-reactive protein; HDL-C = high-density lipoprotein-cholesterol; LDL-C = low-density lipoprotein-cholesterol; SBP = systolic blood pressure; total chol = total cholesterol.  
— Age-and race/ethnicity-adjusted means of cardiovascular risk factors among girls. Note. The first 2 bars represent age-and race/ethnicity-adjusted means and 95% confidence intervals of the 'fit' and 'not fit' groups. The last 4 bars represent age-, race/ethnicity-, and waist circumference-adjusted means and 95% confidence intervals of the 'fit' and 'not fit' groups within the 'not fat' and 'fat' groups. * Five cardiovascular risk factors were significantly different between the 'fit' and 'not fit' groups (P < .05). † After adjustment for fatness, only total cholesterol levels were significantly different between the 'fit' and 'not fit' groups (P < .05). CRP = C-reactive protein, LDL-C = low-density lipoprotein-cholesterol; SBP = systolic blood pressure; total chol = total cholesterol.  
Article
This study aimed to examine combined and independent effects of cardiorespiratory fitness and fatness on cardiovascular risk factors among U.S. adolescents. Data from adolescents age 12 to 19 years participating in the NHANES 1999 to 2002 were used. Fitness level was determined by submaximal treadmill test and was dichotomized as 'not fit' or 'fit' according to the FITNESSGRAM. Fatness level was categorized as 'not fat' or 'fat' based on the CDC BMI growth charts. Gender-specific multivariable linear regression analyses were conducted to compare age-, race/ethnicity-, fatness-, and waist circumference-adjusted means of blood pressure, lipids, lipoproteins, C-peptide, insulin, and C-reactive protein (CRP) levels. A total of 3202 adolescents (1629 boys) were included for data analysis. Among boys, total cholesterol, triglycerides, insulin, and CRP mean levels were significantly higher (P < .05) in the 'not fit' group than in the 'fit' group, after adjustment for fatness level and waist circumference. Among girls, the fatness level- and waist circumference-adjusted means of total cholesterol (P < .01) and LDL-C (P < .09) were higher in the 'not fit' than 'fit' groups. Cardiorespiratory fitness, independent of fatness, may have beneficial effects on lipid profiles among girls, and on lipid profiles, insulin metabolism, and inflammation levels among boys.
 
Article
To help inform policies and programs, a need exists to understand the extent to which Healthy People 2010 objectives for physical activity, physical education (PE), and television (TV) viewing among adolescents are being achieved. As part of the Youth Risk Behavior Surveillance System, 5 national school-based surveys were conducted biennially from 1999 through 2007. Each survey used a 3-stage cross-sectional sample of students in grades 9 to 12 and provided self-reported data from approximately 14,000 students. Logistic regression models that controlled for sex, race/ethnicity, and grade were used to analyze secular trends. During 1999 to 2007, prevalence estimates for regular participation in moderate and vigorous physical activity, participation in daily PE classes, and being physically active in PE classes did not change significantly among female, male, white, black, or Hispanic students. In contrast, the prevalence of TV viewing for 2 or fewer hours on a school day increased significantly among female, male, white, black, and Hispanic students and among students in every grade except 12th grade. Among US adolescents, no significant progress has been made toward increasing participation in physical activity or school PE classes; however, improvements have been made in reducing TV viewing time.
 
Article
Adults integrate walking into their leisure-time (LT) in a variety of ways, including the use of walking as their only outlet for leisure-time physical activity (LTPA). The purpose of this study was to examine how LT walking relates to compliance with the 2007 ACSM/AHA guidelines for aerobic-related physical activity (PA). The study sample (N = 14,470 adults, 20+ years of age) came from the 1999 to 2004 NHANES. PA Interviews (past month) allowed each LT active subject to be classified by walking behavior (LTPA Active-No Walking, Walking-Only, Walking-Plus other LTPA). Walking prevalence, frequency (bouts per week), duration (minutes per bout), and compliance with ACSM/AHA recommendations were examined in SUDAAN. Overall, 34.4% of adults in the U.S. walk in their LT. Among these active LT walkers, 34.8% were Walking-Only and 65.2% were Walking-Plus adults. Related to compliance with PA recommendations, Walking-Only (29.4%; 95% CI = 26.3 to 32.5) adults were significantly less likely than Walking-Plus (74.6%; 95% CI = 72.6 to 76.7) adults to be compliant with guidelines. The frequency of LTPA explains this difference in compliance (3.4 vs. 7.6 bouts/week, respectively). Walking-Only adults should be targeted for increased compliance with PA recommendations by promoting walking frequency and added variety among LTPAs.
 
Article
We examined leisure-time physical activity (LTPA) in US adults 60 or more years of age. After determining the prevalence of 3 levels of LTPA (no LTPA, <150 minutes LTPA/wk, and > or =150 minutes of LTPA/ wk), we examined the association of demographic variables and current health status with LTPA. Self-reported LTPA was examined by gender, age, race/ethnicity, education, family poverty income ratio, marital status, and self-reported health. Multiple logistic regression methods were used in the adjusted model. Walking was the most frequently reported LTPA. Overall, 27% of adults achieved LTPA levels of 150 minutes or more per week. Male gender, younger age, non-Hispanic white race/ethnicity, higher education attainment, higher income status, being married, and excellent self-reported health were associated with higher LTPA. The prevalence of no LTPA (52.5%) exceeded the Healthy People 2010 objective target of 20%. Our findings show that more than half of adults 60 or more years of age reported no LTPA and that levels of LTPA in the older population vary by demographic and health characteristics.
 
Article
Commuting reflects an important opportunity for youth to engage in physical activity. This study aimed to compare modes of commuting to school and to work and to identify socio-demographic factors associated with various modes of transportation. Epidemiologic study with a repeated cross-sectional design. Participants included high school students (15-19 years of age) from Santa Catarina state, Brazil, in 2001 (n= 5028) and 2011 (n= 6529). A questionnaire containing information on the type of transport used to commute to school and to work was administered. Walking/bicycling and the use of the bus to commute to school and to work remained stable after a decade; however, the use of car/motorcycle to school (6.4% versus 12.6%) and to work (10.2% versus 19.7%) increased significantly. In both cases, females more frequently used buses, whereas males commuted to work by car/bus. Students from rural areas more commonly commuted to school by car/motorcycle, whereas those from urban areas traveled to work more by bus. There was a greater use of cars/motorcycles by young people from higher-income families. The use of cars/motorcycles to commute to school/work has almost doubled in the last decade. Sex, residential area and income were associated with passive commuting.
 
Article
This intervention promoted stair use among people attending the American College of Sports Medicine (ACSM) annual meeting. All attendees using the stairs or escalators in the main lobby were unobtrusively observed for 3 days and coded for activity choices to get to the second floor. During day 2, a prominent sign stating "Be a role model. Use the stairs!" encouraged pointof- choice decisions favoring stairs over the escalator. The sign was removed on day 3. 16,978 observations were made. Stair use increased from 22.0% on day 1 to 29.3% and 26.8% on days 2 and 3, respectively (P values < .001). Active choices (stair use or walk up escalator) increased from 28.3% on day 1 to 40.1% and 40.2% on subsequent days. Analyses were similar after adjustment for gender, estimated age category, and race. Relatively few conference attendees were persuaded to model stair-use behavior. Health professionals should be encouraged to be "active living" role models.
 
Article
Walking for exercise is a popular leisure-time activity pursuit among US adults; however, little information is available about total daily walking. A nationally representative random sample of 10,461 US adults (4,438 men and 6,023 women) was surveyed via telephone between 2002 and 2003. Weekly frequency and daily duration of walking for all purposes in bouts of at least 10 min were measured. Regular walking was defined as walking > or =5 d/wk, > or =30 min/d. Overall, 49% of adults (51% of men and 47% of women) were regular walkers, and approximately 17% reported no walking. Regular walking was significantly higher in employed adults and decreased with increasing age in women and body mass index in both sexes. Total walking was significantly higher among adults with lower levels of educational attainment and did not vary significantly by race/ethnicity. These results affirm the popularity of walking in the United States.
 
Article
The Current Population Survey (CPS) and the American Time Use Survey (ATUS) use the 2002 census occupation system to classify workers into 509 separate occupations arranged into 22 major occupational categories. We describe the methods and rationale for assigning detailed Metabolic Equivalent (MET) estimates to occupations and present population estimates (comparing outputs generated by analysis of previously published summary MET estimates to the detailed MET estimates) of intensities of occupational activity using the 2003 ATUS data comprised of 20,720 respondents, 5323 (2917 males and 2406 females) of whom reported working 6+ hours at their primary occupation on their assigned reporting day. Analysis using the summary MET estimates resulted in 4% more workers in sedentary occupations, 6% more in light, 7% less in moderate, and 3% less in vigorous compared with using the detailed MET estimates. The detailed estimates are more sensitive to identifying individuals who do any occupational activity that is moderate or vigorous in intensity resulting in fewer workers in sedentary and light intensity occupations. Since CPS/ATUS regularly captures occupation data it will be possible to track prevalence of the different intensity levels of occupations. Updates will be required with inevitable adjustments to future occupational classification systems.
 
Article
We estimated percentages of US adults (>/=18 years) who knew that prior federal physical activity (PA) guidelines call for a minimum of 30 minutes of moderate-intensity PA most days (>/=5)/week using 2003 to 2005 HealthStyles, an annual mail survey. 10,117 participants identified "the minimum amount of moderate-intensity PA the government recommends to get overall health benefits." Response options included 30/>/=5, 20/>/=3, 30/7, and 60/7 (minutes/days per week), "none of these," and "don't know." The odds of correctly identifying the guideline was modeled by participant sex, age, race/ethnicity, income, education, marital status, body mass index, physical activity level, and survey year using logistic regression. 25.6% of respondents correctly identified the guideline. Women were 30% more likely to identify the guideline than men (Odds Ratio [95% Confidence Limits] (OR) = 1.28 [1.15, 1.44]). Regular PA was positively associated with identifying the guideline versus inactivity (OR = 2.08 [1.73, 2.50]). Blacks and those earning <$15,000 annually were 24% to 32% less likely to identify the guideline than whites and those earning >$60,000, respectively. Most adults did not know the previous moderate-intensity PA recommendation, which indicates a need for effective communication strategies for the new 2008 Physical Activity Guidelines for Adults.
 
Article
We report walking for shopping, exercise, transportation, and walking the dog, among other sources captured in the 2003 to 2005 American Time Use Survey (ATUS). We extracted and analyzed 8 walking behaviors (by sex, age, education level, and race/ethnicity) from 24 hours of activities recalled by telephone interview for 15,175 males and 19,518 females age<15 years. On any given day in 2003 to 2005, 45.8% of Americans participated in a median of 45 minutes of any walking activities; 31.6% walked for shopping purposes, 12.5% walked for transportation, 4.8% walked for exercise, and 2.5% walked the dog. College-educated respondents more commonly reported walking while shopping, walking for exercise, and dog walking. Those with less than a high school education more commonly reported walking for transportation. Despite limitations identified in imputing explicit and implicit performance of walking behaviors in the ATUS, Americans engage in a wide variety of walking behaviors that are not well represented by surveys focused only on leisure-time behaviors. Public health implications include increased availability of multiple and varied opportunities for walking, especially through environmental shifts toward more walkable places and destinations and policy shifts that support walking behaviors over competing transportation modes.
 
— Trends of physical inactivity. Proportion of individuals with a 0 minute score of leisure-time physical activity. 
Article
Most of physical activity surveillance data are derived from high-income countries. The aim of the current study was to report time trends in leisure-time physical activity. Population-based surveys were conducted in the city of Pelotas, Brazil in 2003 and 2010, including individuals aged 20+ years. Physical activity was assessed using the leisure-time section of the long version of the IPAQ. A cut-off point of 150 min/wk was used in the analyses. Methodologies were virtually identical in both surveys. In 2003, 26.8% (95%CI 24.3; 29.2) of the participants were classified as active in leisure-time, as compared to 24.4% (95%CI 22.6; 26.2) in 2010. The proportion of subjects reporting zero minutes per week of walking, moderate- and vigorous-intensity physical activity practice also did not vary between 2003 and 2010. However, the proportion of active adults decreased from 39.9% (95%CI 33.0; 42.7) in 2003 to 29.7% (95%CI 24.9; 34.5) in 2010 among high-income participants. Males were more active than females in both surveys. Leisure-time physical activity is stable among adults living in the South of Brazil, but high-income participants are becoming less active over time. Scaling up effective and promising physical activity interventions is urgently needed in Brazil.
 
Article
Background: Socioeconomic status (SES) and acculturation are potential contributors of adolescent physical activity disparity among ethnic groups in the U.S. However, studies relying on self-report physical activity measures have reported inconsistent findings regarding sociocultural predictors of physical activity. Therefore, the current study examined the main and interactive effects of SES and acculturation on accelerometer-measured moderate-to-vigorous intensity physical activity (MVPA) among Mexican American adolescents. Methods: The National Health and Nutrition Examination Survey 2003-2004 was analyzed. Samples of 153 and 169 Mexican American boys and girls, respectively, were analyzed. SES was indicated by poverty-to-income ratio (PIR); and acculturation was measured by 5-item English preference scales and adolescent and parental country of birth. Regression models were tested separately for boys and girls. Results: U.S.-born boys compared with immigrants did more MVPA (β = .48, P < .01). On the contrary, the effect of English preference on MVPA in boys was negative (β = -.05, P < .01) and amplified by higher SES (β = -.02, P < .01). For girls, none of the tested variables were significant. Conclusions: Higher SES was a risk factor for physical inactivity in Mexican American adolescents, by a moderating mechanism. In addition, physical activity promotion efforts need to consider English speaking and immigrant Mexican American adolescent boys as a target population.
 
An Example of Simulation Data Generation for 3-days of Monitoring Frame with 2-week Days and 1-weekend Day
Descriptive Statistics of Step-Count Measures for the Total Sample by Gender and Age Group 
Article
This study examined the optimal measurement conditions to obtain reliable peak cadence measures using the accelerometer-determined step data from the NHANES 2005-2006. A total of 1,282 adults (>17years) who provided valid accelerometer data for 7 consecutive days were included. The peak 1-and 30-minute cadences were extracted. The sources of variance in peak stepping cadences were estimated using Generalizability theory analysis. A simulation analysis was conducted to examine the effect of the inclusion of weekend days. The optimal number of monitoring days to achieve 80% reliability for peak stepping cadences were estimated. Intra-individual variability was the largest variance component of peak cadences for young and middle-aged adults aged <60 years (50.55%-59.24%) compared to older adults aged ≥60 years (31.62%-41.72%). In general, the minimum of 7and 5days of monitoring were required for peak 1-and 30-minute cadences among young and middle-aged adults, while 3 days of monitoring was sufficient for older adults to achieve the desired reliability (.80). The inclusion of weekend days in the monitoring frame may not be practically important. The findings could be applied in future research as the reference measurement conditions for peak cadences.
 
Article
Background: Analysis of the 2005-2006 National Health and Nutrition Examination Survey (NHANES) accelerometer data provides the descriptive epidemiology of peak 30-minute cadence (defined as the average steps/min recorded for the 30 highest, but not necessarily consecutive, minutes in a day) and peak 1-minute cadence (defined as the steps/min recorded for the highest single minute in a day) by sex, age, and body mass index (BMI). Methods: Minute-by-minute step data were rank ordered each day to identify the peak 30-minute and 1-minute cadences for 3522 adults (20+ years of age) with complete sex, age, and BMI data and at least 1 valid day (ie, 10/24 hours of accelerometer wear) of accelerometer data. Peak values were averaged across days within participants by sex, age, and BMI-defined categories. Results: U.S. adults average a peak 30-minute cadence of 71.1 (men: 73.7, women: 69.6, P < .0001) steps/min and a peak 1-minute cadence of 100.7 (men: 100.9, women: 100.5, P = .54) steps/min. Both peak cadence indicators displayed significant and consistent declines with age and increasing levels of obesity. Conclusions: Peak cadence indicators capture the highest intensity execution of naturally occurring ambulatory activity. Future examination of their relationship with health parameters using cross-sectional, longitudinal, and intervention designs is warranted.
 
Age-standardized prevalence and adjusted* relative odds of 14 or more unhealthy physical days by physical activity level and self-reported body-mass index, BRFSS 2005. *Adjusted for age (continuous), sex, race/ethnicity, education, employment, smoking, diabetes, arthritis, and cardiovascular disease. 
Age-standardized prevalence and adjusted* relative odds of 14 or more unhealthy mental days by physical activity level and self-reported body-mass index, BRFSS 2005. *Adjusted for age (continuous), sex, race/ethnicity, education, employment, smoking, diabetes, arthritis, and cardiovascular disease. 
Article
Since overweight (25 < or = BMI < 30) and obesity (BMI > or = 30 Kg/m2) are associated with poor health-related quality of life (HRQOL) and regular physical activity is associated with higher levels of HRQOL, the authors examined the relationship between physical activity and HRQOL among overweight and obese adults (age > or = 18 years) residing in the United States. Using the 2005 BRFSS survey, they examined the independent relationship between recommended physical activity and measures of HRQOL developed by the Centers for Disease Control and Prevention among 283,562 adults age 18 years or older with overweight or obesity. Measures of physical activity, height, weight, and HRQOL were self-reported. Multivariable logistic regression was used to obtain odds ratios and 95% confidence intervals adjusted for age, race/ethnicity, sex, education, smoking status, chronic disease, and body-mass index. The proportion of adults with overweight and obesity who attained recommended levels of physical activity had higher levels of HRQOL than physically inactive adults for all age, racial/ethnic, and sex groups. After multivariable adjustment, overweight and obese adults who met the recommended level of physical activity had higher levels of HRQOL than physically inactive adults across all age strata. These results highlight the HRQOL role that physical activity can have among overweight and obese persons despite their excess body weight.
 
— Geographical distribution of cities funded by the Brazilian Ministry of Health (2005–2008) to carry out physical activity interventions. 
Distribution of the Cities Funded by the Brazilian Ministry of Health (2005-2008) to Carry Out Physical Activity Interventions According to Their Region
Description of Process Indicators Among Cities Funded by the Brazilian Ministry of Health (2006-2007) to Carry Out Physical Activity Interventions
Article
Based on the Brazilian National Health Promotion Policy (PNPS), the Ministry of Health (MoH) started stimulating and funding physical activity interventions in 2005, leading to the establishment of a countrywide network. The aim of the present article is to geographically describe this network (2005-2008) and to present structure and process evaluation indicators of interventions funded in 2006 and 2007. In 2005, the 27 state capitals received funding for carrying out physical activity-related interventions. From 2006 onwards, public calls for proposals were announced, and cities were selected through a competitive basis. Coordinators of interventions in cities who got funding in 2006 and 2007 answered to survey questions on structure and process aspects of the interventions. The network currently comprises 469 projects, out of which over 60% are carried out in small cities (<30,000 inhabitants). The most frequently used public spaces for the interventions are squares and indoor sports courts. The main physical activity-related topic of the PNPS prioritized in the projects is healthy diet. The main partnerships developed are between City's Health and Education Secretariats. Expanding the network to 1000 cities by 2010 and continuing the evaluation efforts are the next goals of the Brazilian MoH.
 
Article
Background: Pedometers are becoming widely accepted for physical activity measurement. To use step data effectively, an index which categorizes steps/day by < 5000, ≥ 5000, ≥ 7500, ≥ 10,000, and ≥ 12,500 steps/day has been previously proposed. However, evidence is insufficient to validate this index compared with health outcomes. This study examined the association of steps/day categories with cardiovascular (CVD) risk. Methods: Cross-sectional data from the National Health and Nutrition Survey of Japan 2006, including 1166 men and 1453 women aged 40-64 years, were analyzed to calculate odds ratios (OR) for having CVD risk including overweight/obesity, blood pressure, high density lipoprotein cholesterol, hemoglobin A1c, and clustered risk factors by steps/day categories. Results: Among men, inverse gradient associations between steps/day categories and CVD risk (overweight/obesity, blood pressure, HbA1c, and clustered risk factors) were observed. Among women, those taking ≥ 5000 steps/day had substantially lower risk of overweight/obesity and high blood pressure compared with those taking < 5000 steps/day. However, additional decreases of OR by taking more steps were modest among women. Conclusions: CVD risk was generally lower with higher steps/day categories. Given the limitations of cross-sectional design, further studies, especially using longitudinal designs, are needed to precisely calibrate the association between steps/day and CVD risk.
 
Article
Most ischemic heart disease (IHD) prevention programs that promote physical activity (PA) have focused on overweight/obese populations. Persons with normal body mass index (BMI) may mistakenly think that they are not at risk for IHD and remain physically inactive. Studies exploring the risk of IHD and PA level among adults aged 45 years and older with normal weight are limited. Cross-sectional study to examine the prevalence of IHD and PA level among 94455 respondents aged 45 years and older with normal BMI using the 2007 Behavioral Risk Factor Surveillance System data. Approximately 50% of respondents reported low/inactive PA. The prevalence of IHD among persons with inactive, low, medium, and high PA was 16.6% (95% CI=15.1-18.1%), 9.6% (8.9-10.3%), 8.9% (8.3-9.6%), and 5.4% (4.9-5.9%). The adjusted odds ratios of IHD among persons with low, medium, and high PA compared with those with inactive PA was 0.68 (95% CI=0.59-0.79), 0.63 (0.54-0.73), and 0.49 (0.42-0.57). The percentage of respondents with low or inactive PA among populations aged 45 years and older with BMI 18 to <25 was alarmingly high and independently associated with higher IHD prevalence. Persons who are not overweight/obese still need to have adequate PA to reduce the risk of IHD.
 
Article
Physical inactivity is a modifiable risk factor for obesity, diabetes, cardiovascular diseases, and certain types of cancer. This study aimed to investigate the patterns and demographic correlates of physical activity in Iran. The data collected through the third national surveillance of risk factors of noncommunicable diseases (SuRFNCD-2007) on 4120 adults were studied. Physical activity was assessed by the global physical activity questionnaire (GPAQ) in domains of work, commuting and recreation. Participants were categorized into low, moderate and high activity categories. Total physical activity (TPA) was calculated using metabolic equivalents (MET). 40% of Iranian adults (31.6% of men and 48.6% of women) belonged to the low physical activity category. The median value of TPA was 206 (342 in men and 129 in women) MET-minutes/day. Physical activity at work, commuting and recreation contributed to 71%, 20% and 9% of TPA, respectively. Approximately 15% of Iranian adults (4.7 million people) do not have any physical activity in any of the 3 studied domains. Physical inactivity is common in Iran, particularly in females and in the older age groups. Preventing a rapid growth of conditions such as diabetes and cardiovascular diseases requires health programs with more focus on physical activity.
 
Weighted Sample Descriptives by Immigrant Generation 
Correlates of Overweight by Immigrant Generation and Weight Status 
Article
This study examines relations between parent and youth physical activity (PA; days per week), sports participation, and overweight (BMI ≥ 85th percentile) among U.S. youth, and whether this relationship varies by immigrant generation and sex. Participants included 28,691 youth ages 10-17 years from the 2007 National Survey of Children's Health. Youth were grouped into first, second, and third or higher generation. Primary analyses include Chi-square and post hoc tests to assess mean differences, and adjusted logistic regressions to test associations between weight status and independent variables. Each additional day youth participated in PA decreased their odds of overweight (OW) by 10% [OR: 0.90 (0.87-0.94)]; participation in sports significantly reduced their odds of OW by 17% [OR: 0.83 (0.71-0.98)]. First generation boys who participated in sports had 70% lower odds of OW [OR: 0.30 (0.11-0.83)] compared with first generation boys who did not participate in sports. For third generation girls, participation in sports reduced the odds of OW by 23% [OR: 0.77 (0.62-0.96)] compared with those who did not participate in sports. The protective influence of PA on youth's risk of OW varies by immigrant generation and sex. Parent PA was not related to youth's risk of OW.
 
Top-cited authors
Thomas L Mckenzie
  • San Diego State University
Kelli L Cain
  • University of California, San Diego
Delfien Van Dyck
  • Ghent University
Peter Katzmarzyk
  • Pennington Biomedical Research Center
Deborah A Cohen
  • RAND Corporation