Dose-response relation of self-reported and accelerometer-measured physical activity to perceived health in middle age\u2014the Northern Finland Birth Cohort 1966 Study

Maisa S Niemelä,Anna-Maiju Leinonen,Tuija H Tammelin,Maarit Kangas,Raija I Korpelainen,Eeva S Vaaramo,Sirkka M Keinänen-Kiukaanniemi,Timo J Jämsä,Riikka J Ahola,Juha P Auvinen

doi:10.1186/s12889-018-6359-8

Abstract

BackgroundRegular physical activity (PA) promotes health and decreases mortality. The positive relationship between PA and perceived health (PH) is well known. However, previous research in the field has often used self-reported PA measures. The aim of this population-based NFBC1966 birth cohort study was to assess the relationship between both self-reported and objectively measured PA and PH in midlife.MethodsA sample group of 6384 participants (2878 men, 3506 women, response rate 62%) aged 46 completed a questionnaire on PH and health behaviors, including items on weekly leisure time physical activity (LTPA) and daily sitting time (ST). PH was dichotomized as good (very good or good) and other (fair, poor, or very poor). PA was measured with a wrist-worn Polar Active (Polar Electro, Finland) accelerometer for 14 days (n = 5481, 98%) and expressed as daily average time spent in moderate to vigorous intensity PA (MVPA). Odds ratios (OR) and 95% confidence intervals for good PH were calculated using binary logistic regression and adjusted for relevant demographic, socioeconomic, and health characteristics, and ST.ResultsThe level of PA was positively associated with PH after adjustments with covariates and ST. There was a dose-response relationship across the PA quartiles according to the adjusted multivariable models. Self-reported LTPA was more strongly associated with good PH (OR from 1.72 to 4.33 compared to lowest PA quartile) than objectively measured PA (OR from 1.37 to 1.66 compared to lowest PA quartile).ConclusionsIn this large population-based birth cohort study, we for the first time show a positive dose-response relationship of both self-reported and objectively measured PA to PH, the relationship being stronger for self-reported LTPA. Despite the cross-sectional design of this study, the results from this large sample suggest that both self-reported and objectively measured physical activity are strongly associated with PH, which is a predictor of morbidity and mortality, and regular PA should be encouraged in midlife.

Highlights

Regular physical activity (PA) promotes health and decreases mortality
Social, and work-related factors have been identified as determinants of perceived health (PH) [3, 5, 6], and it has been acknowledged that people with similar health conditions may provide different answers to a PH question [7]
The PA questionnaire was completed by 6384 participants, and sitting time (ST) questions were answered by 6735 participants

Summary

Introduction

Regular physical activity (PA) promotes health and decreases mortality. The positive relationship between PA and perceived health (PH) is well known. PH has been shown to be associated with mortality, morbidity, and objective health status [2, 3] and to predict mortality after controlling for objective health status [2]. In some cases, it has been an even stronger predictor of survival than medical records [4]. PH includes components beyond objective health status, as Maddox and Douglass noted decades ago: “These ratings clearly measure something more— and something less—than objective medical rating” [8]

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