Impact of activity outcome and measurement instrument on estimates of youth compliance with physical activity guidelines: a cross-sectional study

Abstract Background The national physical activity guidelines (PAG) in many countries recommend that youth accumulate 60 min or more of moderate-to-vigorous physical activity (MVPA) daily (PAG-MVPA). A daily target of ≥ 11,500 steps/day has been proposed as a step count alternative to this guideline (PAG-Steps). Contemporary activity monitors are capable of estimating both MVPA and steps, but it is not clear how these units compare when used to evaluate compliance with the national PAG. The purpose of this study was to compare prevalence estimates of meeting the PAG-MVPA and PAG-Steps using two commonly used monitors, the ActiGraph (AG) and SenseWear Armband (SWA). Methods A sample of 69 children (25 girls and 44 boys) aged 9–16 years each wore a wrist-mounted AG and a SWA over a one-week period. Days with ≥10 h of wear time for both monitors were included in the analysis. Estimates of time spent in MVPA were obtained using the Crouter equation for the AG and from proprietary algorithms for the SWA. Step counts for the AG and SWA were directly obtained from the respective software. The prevalence of meeting the PAG-MVPA and PAG-Steps was compared within each monitor, using Cohen’s kappa (κ) statistic. Agreement was similarly assessed between monitors using each guideline individually. Results When assessed with the AG, the prevalence of meeting PAG was substantially higher for the PAG-MVPA (87.2 %) than for the PAG-Steps (54.2 %), with fair classification agreement (κ = 0.30) between the two guidelines. Higher prevalence rates were also observed for the PAG-MVPA (83.6 %) than for the PAG-Steps (33.8 %) when assessed using the SWA, but the prevalence rates and classification agreement (κ = 0.18) were lower than the values from the AG. Classification agreement between AG and SWA was lower for the PAG-MVPA (κ = 0.42) than for the PAG-Steps (κ = 0.55). Conclusions The results show differential patterns of compliance with the PAG-MVPA and PAG-Steps, as assessed by the AG and SWA. Additional research is needed to directly evaluate and compare findings from public health research based on different guidelines and measurement methods

Impact of activity outcome and measurement instrument on estimates of youth compliance with physical activity guidelines: a cross-sectional study.

BACKGROUND: The national physical activity guidelines (PAG) in many countries recommend that youth accumulate 60 min or more of moderate-to-vigorous physical activity (MVPA) daily (PAG-MVPA). A daily target of ≥ 11,500 steps/day has been proposed as a step count alternative to this guideline (PAG-Steps). Contemporary activity monitors are capable of estimating both MVPA and steps, but it is not clear how these units compare when used to evaluate compliance with the national PAG. The purpose of this study was to compare prevalence estimates of meeting the PAG-MVPA and PAG-Steps using two commonly used monitors, the ActiGraph (AG) and SenseWear Armband (SWA). METHODS: A sample of 69 children (25 girls and 44 boys) aged 9-16 years each wore a wrist-mounted AG and a SWA over a one-week period. Days with ≥10 h of wear time for both monitors were included in the analysis. Estimates of time spent in MVPA were obtained using the Crouter equation for the AG and from proprietary algorithms for the SWA. Step counts for the AG and SWA were directly obtained from the respective software. The prevalence of meeting the PAG-MVPA and PAG-Steps was compared within each monitor, using Cohen's kappa (κ) statistic. Agreement was similarly assessed between monitors using each guideline individually. RESULTS: When assessed with the AG, the prevalence of meeting PAG was substantially higher for the PAG-MVPA (87.2 %) than for the PAG-Steps (54.2 %), with fair classification agreement (κ = 0.30) between the two guidelines. Higher prevalence rates were also observed for the PAG-MVPA (83.6 %) than for the PAG-Steps (33.8 %) when assessed using the SWA, but the prevalence rates and classification agreement (κ = 0.18) were lower than the values from the AG. Classification agreement between AG and SWA was lower for the PAG-MVPA (κ = 0.42) than for the PAG-Steps (κ = 0.55). CONCLUSIONS: The results show differential patterns of compliance with the PAG-MVPA and PAG-Steps, as assessed by the AG and SWA. Additional research is needed to directly evaluate and compare findings from public health research based on different guidelines and measurement methods

Non-overweight and overweight children’s physical activity during school recess

Objective: Little research has investigated children’s physical activity levels during school recess and the contribution of recess to school day physical activity levels by weight status. The aims of this study were to examine non-overweight and overweight children’s physical activity levels during school recess, and examine the contribution of recess to school day physical activity. Design: Cross-sectional. Setting: Four elementary schools located in Nebraska, United States of America (USA). Methods: Two hundred and seventeen children (99 boys, 118 girls; 47.9% overweight) wore a uni-axial accelerometer for five consecutive school days during autumn 2009. The proportion of time spent engaged in sedentary (SED), light (LPA), moderate (MPA) and vigorous (VPA) intensity physical activity during recess was determined using age-specific accelerometer thresholds. Results: Overweight children engaged in more %MPA and less %VPA than non-overweight children, respectively. No differences were found between overweight and healthy weight children’s moderateto-vigorous physical activity (MVPA). Recess contributed 16.9% and 16.3% towards non-overweight and overweight children’s school day %MVPA, respectively. Conclusion: Examining %MVPA as an outcome variable may mask differences in recess physical activity levels between non-overweight and overweight children. Future research is needed to establish why healthy weight and overweight children engage in differing levels of %MPA and %VPA during recess

Rest-Activity Profiles among Us adults in a Nationally Representative Sample: a Functional Principal Component analysis

BACKGROUND: The 24-h rest and activity behaviors (i.e., physical activity, sedentary behaviors and sleep) are fundamental human behaviors essential to health and well-being. Functional principal component analysis (fPCA) is a flexible approach for characterizing rest-activity rhythms and does not rely on a priori assumptions about the activity shape. The objective of our study is to apply fPCA to a nationally representative sample of American adults to characterize variations in the 24-h rest-activity pattern, determine how the pattern differs according to demographic, socioeconomic and work characteristics, and examine its associations with general health status. METHODS: The current analysis used data from adults 25 or older in the National Health and Nutrition Examination Survey (NHANES, 2011-2014). Using 7-day 24-h actigraphy recordings, we applied fPCA to derive profiles for overall, weekday and weekend rest-activity patterns. We examined the association between each rest-activity profile in relation to age, gender, race/ethnicity, education, income and working status using multiple linear regression. We also used multiple logistic regression to determine the relationship between each rest-activity profile and the likelihood of reporting poor or fair health. RESULTS: We identified four distinct profiles (i.e., high amplitude, early rise, prolonged activity window, biphasic pattern) that together accounted for 86.8% of total variation in the study sample. We identified numerous associations between each rest-activity profile and multiple sociodemographic characteristics. We also found evidence suggesting the associations differed between weekdays and weekends. Finally, we reported that the rest-activity profiles were associated with self-rated health. CONCLUSIONS: Our study provided evidence suggesting that rest-activity patterns in human populations are shaped by multiple demographic, socioeconomic and work factors, and are correlated with health status

Leisure time physical activity throughout adulthood is associated with lower medicare costs : Evidence from the linked nih-aarp diet and health study cohort

Background There is limited information about the association between long-term leisure time physical activity (LTPA) participation and healthcare costs. The purpose of this study was to investigate the association LTPA over adulthood with later life healthcare costs in the USA. Methods Using Medicare claims data (between 1999 and 2008) linked to the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study, we examined associations between nine trajectories of physical activity participation throughout adulthood with Medicare costs. Results Compared with adults who were consistently inactive from adolescence into middle age, average annual healthcare costs were significantly lower for maintainers, adults who maintained moderate (-US$1350 (95$2009 to-US$690) or-15.9$1200 (95% CI:-US$1777 to-US$622) or-14.1% (95% CI:-20.9% to-7.3%)) and increasers, adults who increased physical activity levels in early adulthood (-US$1874 (95$2691 to-US$1057) or-22.0$824 (95% CI:-US$1580 to-US$69 or-9.7% (95% CI-18.6% to-0.8%)). For the four trajectories where physical activity decreased, the only significant difference was for adults who increased physical activity levels during early adulthood with a decline in middle age (-US$861 (95$1678 to-US$45) or-10.1% (95% CI:-19.7% to-0.5%)). Conclusion Our analyses suggest the healthcare cost burden in later life could be reduced through promotion efforts supporting physical activity participation throughout adulthood

Accelerometer and self-reported measures of sedentary behaviour and associations with adiposity in UK youth

This study used accelerometer and self-report measures of overall sedentary time (ST) and screen time behaviours to examine their respective associations with adiposity among UK youth. Participants (Year groups 5, 8, and 10; n=292, 148 girls) wore the SenseWear Armband Mini accelerometer for eight days and completed the Youth Activity Profile, an online report tool designed to estimate physical activity and ST.Stature, body mass and waist circumference were measured to classify adiposity outcomes (overweight/obese and central obesity). One-way between groups ANOVA and adjusted linear, logistic and multinomial logistic regression analyses were conducted. There was a significant main effect of age on total ST across the whole week (F(2, 289)=41.64, p≤0.001). ST increased monotonically across Year 5 (581.09±107.81 min·dˉ¹), 8 (671.96±112.59 min·dˉ¹) and 10 (725.80±115.20 min·dˉ¹), and all pairwise comparisons were significant at p≤0.001. A steep age-related gradient to mobile phone use was present (p≤0.001). ST was positively associated with adiposity outcomes independent of moderate-to-vigorous intensity physical activity (MVPA; p≤0.001). Engaging in >3 hours of video gaming daily was positively associated with central obesity (OR=2.12, p≤0.05) but not after adjustment for MVPA. Results further demonstrate the importance of reducing overall ST to maintain healthy weight status among UK youth

Prospective associations between accelerometry-derived physical activity and sedentary behaviors and mortality among cancer survivors

BACKGROUND: Survival benefits of self-reported recreational physical activity (PA) during cancer survivorship are well-documented in common cancer types, yet there are limited data on the associations between accelerometer-derived PA of all domains, sedentary behavior, and mortality in large, diverse cohorts of cancer survivors. METHODS: Participants included adults who reported a cancer diagnosis in the National Health and Nutrition Examination Survey and wore an accelerometer for up to 7 days in 2003-2006. Participants were followed for subsequent mortality through 2015. We examined the association of light PA, moderate to vigorous PA, total PA, and sedentary behavior, with all-cause mortality. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for demographics and health indicators. RESULTS: A total of 480 participants (mean age of 68.8 years [SD = 12.4] at the time of National Health and Nutrition Examination Survey assessment) reported a history of cancer. A total of 215 deaths occurred over the follow-up period. For every 1-h/d increase in light PA and moderate to vigorous PA (MVPA), cancer survivors had 49% (HR = 0.51, 95% CI = 0.34 to 0.76) and 37% (HR = 0.63 , 95% CI = 0.40 to 0.99) lower hazards of all-cause mortality, respectively. Total PA demonstrated similar associations with statistically significantly lower hazards of death for each additional hour per day (HR = 0.68, 95% CI = 0.54 to 0.85), as did every metabolic equivalents of task-hour per day increase in total PA estimations of energy expenditure (HR = 0.88, 95% CI = 0.82 to 0.95). Conversely, more sedentary time (1 h/d) was not associated with statistically significantly higher hazards (HR = 1.08, 95% CI = 0.94 to 1.23). CONCLUSIONS: These findings reinforce the current recommendations for cancer survivors to be physically active and underscore the continued need for widespread PA promotion for long-term survival in older cancer survivors

Use of previous-day recalls of physical activity and sedentary behavior in epidemiologic studies: results from four instruments.

BACKGROUND: The last few years have seen renewed interest in use-of-time recalls in epidemiological studies, driven by a focus on the 24-h day [including sleep, sitting, and light physical activity (LPA)] rather than just moderate-vigorous physical activity (MVPA). This paper describes four different computerised use-of-time instruments (ACT24, PAR, MARCA and cpar24) and presents population time-use data from a collective sample of 8286 adults from different population studies conducted in Australia/New Zealand, Germany and the United States. METHODS: The instruments were developed independently but showed a number of similarities: they were self-administered through the web or used computer-assisted telephone interviews; all captured energy expenditure using variants of the Ainsworth Compendium; each had been validated against criterion measures; and they used a domain structure whereby activities were aggregated under categories such as Personal Care and Work. RESULTS: Estimates of physical activity level (average daily rate of energy expenditure in METs) ranged from 1.53 to 1.78 in the four studies, strikingly similar to population estimates derived from doubly labelled water. There was broad agreement in the amount of time spent in sleep (7.2-8.6 h), MVPA (1.6-3.1 h), personal care (1.6-2.4 h), and transportation (1.1-1.8 h). There were consistent sex differences, with women spending 28-81% more time on chores, 8-40% more time in LPA, and 3-39% less time in MVPA than men. CONCLUSIONS: Although there were many similarities between instruments, differences in operationalizing definitions of sedentary behaviour and LPA resulted in substantive differences in the amounts of time reported in sedentary and physically active behaviours. Future research should focus on deriving a core set of basic activities and associated energy expenditure estimates, an agreed classificatory hierarchy for the major behavioural and activity domains, and systems to capture relevant social and environmental contexts

Calibration and Validation of the Youth Activity Profile as a Physical Activity and Sedentary Behaviour Surveillance Tool for English Youth

Self-reported youth physical activity (PA) is typically overestimated. We aimed to calibrate and validate a self-report tool among English youth. Four-hundred-and-two participants (aged 9–16 years; 212 boys) wore SenseWear Armband Mini devices (SWA) for eight days and completed the self-report Youth Activity Profile (YAP) on the eighth day. Calibration algorithms for temporally matched segments were generated from the YAP data using quantile regression. The algorithms were applied in an independent cross-validation sample, and student- and school-level agreement were assessed. The utility of the YAP algorithms to assess compliance to PA guidelines was also examined. The school-level bias for the YAP estimates of in-school, out-of-school, and weekend moderate-to-vigorous PA (MVPA) were 17.2 (34.4), 31.6 (14.0), and -4.9 (3.6) min week, respectively. Out-of-school sedentary behaviour (SB) was over-predicted by 109.2 (11.8) min·week−1. Predicted YAP values were within 15%–20% equivalence of the SWA estimates. The classification accuracy of the YAP MVPA estimates for compliance to 60 min·day−1 and 30 min·school-day−1 MVPA recommendations were 91%/37% and 89%/57% sensitivity/specificity, respectively. The YAP generated robust school-level estimates of MVPA and SB and has potential for surveillance to monitor compliance with PA guidelines. The accuracy of the YAP may be further improved through research with more representative UK samples to enhance the calibration process and to refine the resultant algorithm