Global Physical Activity Guidelines Research Articles

A narrative review of global and national physical activity and sedentary behaviour guidelines development processes - The GUidelines Standards (GUS) project

BackgroundClinical and public health guidelines serve to direct clinical practice and policy, based on the best available evidence. The World Health Organization (WHO) and national health bodies of many countries have released physical activity and sedentary behaviour guidelines. Despite significant overlap in the body of evidence reviewed, the guidelines differ across jurisdictions. This study aimed to review the processes used to develop global and national physical activity and sedentary behaviour guidelines and examine the extent to which they conform with a recommended methodological standard for the development of guidelines. MethodsWe extracted data on nine sets of guidelines from seven jurisdictions (WHO, Australia, Canada, Japan, the Netherlands, United Kingdom, and United States). We rated each set of guidelines as high, medium, or low quality on criteria related to the rigour of the development process. ResultsWe observed variation in the quality of guidelines development processes across jurisdictions and across different criteria. Guidelines received the strongest overall ratings for criteria on clearly describing the evidence selected and stating an explicit link between the recommendations and the supporting evidence. Guidelines received the weakest overall ratings for criteria related to clearly describing the methods used to formulate the recommendations and reporting external review by experts prior to publication. Evaluated against the selected criteria, the strongest processes were undertaken by the WHO and Canada. ConclusionsReaching agreement on acceptable guideline development processes, as well as the inclusion and appraisal procedures of different types of evidence, would help to strengthen and align future guidelines.

Changes In Adherence To Global Physical Activity Guidelines Among Japanese Adults, 1995-2019

Changes In Adherence To Global Physical Activity Guidelines Among Japanese Adults, 1995-2019

Physical Activity Behavior and Its Association With Global Cognitive Function Three Months After Stroke: The Nor-COAST Study†.

The purposes of this study were to determine the association between physical activity (PA) behavior and global cognitive function 3months after stroke and to explore the role of physical capacity as a mediating factor. Participants with stroke were successively recruited at 5 different hospitals in Norway. PA was measured using accelerometers, with a follow-up period of 7 consecutive days, and global cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). The general pattern of PA and the percentage of participants adhering to World Health Organization PA recommendations (at least 150minutes of moderate-intensity aerobic PA per week) were investigated using descriptive statistics. Multiple regression and mediator analyses were used to examine the relationship between PA behavior and MoCA scores; physical capacity, measured with the Short Physical Performance Battery, served as the mediating variable. A total of 193 women (42.6%) and 260 men (57.4%) with a median age of 73.7years (25th and 75th percentiles = 65.8 and 80.4, respectively) and a median MoCA score of 25 points (25th and 75th percentiles = 22 and 27, respectively) were included. Mean total time spent walking at moderate intensity was 251.7 (SD = 164.6) min/wk (mean bout length = 20.9 [SD = 7.3] seconds), which indicated 69.3% adherence to World Health Organization guidelines. With each point decrease in the MoCA score, there was an expected 8.6% increase in the odds of nonadherence to PA recommendations. Physical capacity was identified as an important mediating factor, explaining the strength of the association between cognition and PA behavior. In contrast to previous research, in the present study, most participants adhered to the updated global PA guidelines. However, people who had survived stroke and had reduced cognitive function were at higher risk of inactivity, an association mediated by physical capacity. A better understanding of the association between cognition and PA behavior after stroke might help for developing more targeted early-onset interventions.

The effect of physical activity on health outcomes in people with moderate-to-severe traumatic brain injury: a rapid systematic review with meta-analysis

BackgroundIn 2020, the World Health Organization (WHO) released the first global physical activity and sedentary behaviour guidelines for children and adults living with disability. The evidence informing the guidelines though is not specific to people living with traumatic brain injury (TBI), but rather comes from other disabling conditions such as Parkinson’s disease, and stroke. There remains a clear lack of direct evidence of the effects of physical activity for people living with TBI. The objective of this rapid review was to identify direct evidence of the effect of physical activity on health outcomes in people with moderate-to-severe TBI to inform adaptation of the WHO physical activity guidelines into clinical practice guidelines.MethodsWe conducted a rapid systematic review with meta-analysis of randomised controlled trials, including people of any age with moderate-to-severe TBI, investigating physical activity interventions compared to either usual care, a physical activity intervention with different parameters, or a non-physical activity intervention. Four databases (CENTRAL, SPORTDiscus, PEDro, Ovid MEDLINE) were searched from inception to October 8, 2021. The primary outcomes were physical function, cognition, and quality of life.ResultsTwenty-three studies were included incorporating 812 participants (36% females, majority working-age adults, time post-TBI in studies ranged from 56 days (median) to 16.6 years (mean)). A range of physical activity interventions were evaluated in rehabilitation (n = 12 studies), community (n = 8) and home (n = 3) settings. We pooled data from the end of the intervention for eight outcomes. Participation in a virtual reality physical activity intervention improved mobility, assessed by the Community Balance and Mobility Scale (range 0 to 96; higher score indicates better mobility) more than standard balance training (two studies, 80 participants, Mean Difference = 2.78, 95% CI 1.40 to 4.16; low certainty evidence). There was uncertainty of effect for the remaining outcomes, limited by small sample sizes, diverse comparators and a wide range of outcome measures.ConclusionThis review consolidates the current evidence base for the prescription of physical activity for people with moderate-to-severe TBI. There remains a pressing need for further rigorous research in order to develop practice guidelines to support clinical decision-making when prescribing physical activity in this population.

The relationship between direct care providers' physical activity behaviour and perceived physical activity needs for people with intellectual disabilities.

The promotion of physical activity and the decrease of inactivity and sedentary behaviour are crucial for a healthy lifestyle and positive quality of life. People with intellectual disabilities are at increased risk of inactivity and sedentary behaviour. Therefore, it is important to increase their physical activity by implementing physical activity guidelines in their daily life. Professional direct care providers can play a decisive role in supporting people with intellectual disabilities to participate in physical activity, but the engagement of direct care providers with this role may be reflective of their own attitudes and beliefs towards physical activity. Therefore, the link between the implementation of current physical activity guidelines for people with intellectual disabilities and direct care providers' own beliefs and behaviour with regard to physical activity is investigated. A total of 104 direct care providers completed self-reported questionnaires about their own physical activity behaviour (IPAQ-SF), recommendations for people with intellectual disabilities (adaption of EMIQ-HP) and questions regarding global physical activity guidelines. They were also asked about potential barriers and facilitators for the recommendation of physical activity in open-ended questions. Personal physical activity behaviour is related to the recommended physical activity for people with intellectual disabilities (moderate-to-vigorous physical activity: rs =0.408, P=0.005). However, recommended physical activity behaviour for people with intellectual disabilities is significantly lower than direct care providers' own physical activity behaviour (P<0.001). 47.1% of the respondents recommended people with intellectual disabilities to participate in less than the 150min of moderate intensity physical activity per week for that is recommended in global physical activity guidelines. Direct care providers may hold stereotypical views and insecurities about the potential harms associated with people with intellectual disabilities participating in physical activity. Therefore, the dissemination of physical activity recommendations for people with intellectual disabilities should be a major target for health professionals, social workers and scientists to address direct care providers' concerns. Furthermore, we need to emphasise the benefits of regular physical activity to professional direct care providers and directly to people with intellectual disabilities.

The association between physical activity and psychological well-being in a sample of medicine and health sciences students: a pilot study

Currently, the global physical activity guidelines are based on reducing the risk for mental disorders. More physical activity can decrease the risk for depression by up to 45%. Nevertheless, students of medicine and health sciences are more likely to develop a depression or an anxiety disorder and there is inconsistent evidence regarding the association between self-reported physical activity levels and depressive symptoms in adults. The objective of this study was to evaluate the correlates of anxiety, depression and habitual physical activity in medicine and health sciences students. A questionnaire survey method was employed to carry out this research in March 2020. In all, students (n = 174) of medicine and health sciences of Vilnius University were investigated. Based on present study data, 51.7% of the subjects did not get enough regular physical activity in Lithuania. Almost every third student was diagnosed with case-level anxiety and 4.6% of persons were found with case-level depression. The association between the habitual physical activity and anxiety disorder and/or depression prevalence in medicine and health students could not be explained by the total physical activity score (Adjusted odds ratio (AOR) 0.9; p = 0.914 and AOR 0.7; p = 0.695) or the separate scores of the components such as work index (AOR 2.8; p = 0.201 and AOR 5.4; p = 0.127), sport index (AOR 0.8; p = 0.711 and AOR 1; p = 0.963), leisure-time index of physical activity (AOR 0.7; p = 0.37 and AOR 0.6; p = 0.541).

Muscle-Strengthening Exercise Questionnaire (MSEQ): an assessment of concurrent validity and test–retest reliability

ObjectivesMuscle-strengthening exercise (MSE) has multiple independent health benefits and is a component of global physical activity guidelines. However, the assessment of MSE in health surveillance is often limited to the...

Qatar 2021 National Guidelines on Physical Activity and Sedentary Behaviour: A descriptive review

Background: Regular physical activity (PA) is an effective preventative measure for diverse health risks among all age groups 1. Global PA guidelines provide recommendations on the required levels for active lifestyle based on evidence-based behavioral benchmarks to increase awareness and reduce overall morbidity and mortality rates 2. The Qatar National Physical Activity Guidelines (QNPAG) were first developed in 2014. The recently released QNPAG-2021 provides an updated evidence-based practical guide on PA prescription for practitioners, physicians, educators, and individuals who wish to engage in regular PA. This review aims to provide a summary of how the second QNPAG was developed. Methods: QNPAG was developed by Aspetar Orthopaedic and Sports Medicine Hospital in collaboration with key stakeholders in Qatar; such as the Ministry of Public Health, Qatar University, Hamad Bin Khalifa University, Hamad Medical Corporation, Primary Health Care Corporation, Naufar and others. The steering committee formed a technical advisory group of local and international sport medicine scientists, epidemiologists, and public health experts. Recent literature and global guidelines were evaluated and synthesized. Specific health outcomes and population groups were then proposed taking into consideration the prevalence of diseases, culture, and geographical location. Results: Three main chapters were added on PA benefits and sedentary behavior-associated risks for healthy population; people with medical conditions; and people with special challenging conditions. QNPAG 2021 included additional sections on pandemics, outbreaks and quarantine; humidity and air pollution; substance use; and locations for PA in Qatar. Other topics were added targeting obesity, osteoporosis, cancer, disabilities, mental health disorders, and down&apos;s syndrome. Detailed exercise prescription (Frequency/Intensity/Time/Type), and relevant examples were provided together with safety tips. Conclusion: The updated QNPAG is expected to raise awareness and help increase PA levels in Qatar. However, more emphasis on PA recommendations and strategical implementation is required through promotion, practice, and policies within the different sectors in the country.

Associations between muscle-strengthening exercise and prevalent chronic health conditions in 16,301 adults: Do session duration and weekly volume matter?

ObjectivesMuscle-strengthening exercise (MSE) has multiple health benefits and is part of the global physical activity guidelines. However, with epidemiological research largely focussing on participation frequency (times/week), little is known about the health associations of other parameters. Hence, this study aimed to determine if MSE duration and volume are associated with prevalent chronic health conditions. DesignCross-sectional. MethodsCross-sectional data (n = 16,301 adults ≥16 years) were pooled from the Health Survey for England (2012, 2016). Respondents self-reported MSE mode (own-bodyweight, gym-based), duration and volume, and the prevalence of five chronic conditions (diabetes, anxiety/depression, heart, respiratory, or musculoskeletal condition). Poisson regressions with robust error variance were used to calculate the prevalence ratios (PR) of each chronic condition (outcome variable) across MSE parameters [exposure variables: duration (0 [reference]; 10–20; 21–59; ≥60 min/session); and volume (0 [reference]; low <mean; high ≥mean minutes/week)] for each mode and the modes combined. ResultsMost adults (81.5%) did no MSE. Undertaking any MSE regardless of mode, duration or volume was associated with a reduced likelihood of diabetes (APRs 0.25–0.39), heart (APRs 0.32–0.60), respiratory (APRs 0.49–0.67), and musculoskeletal conditions (APRs 0.43–0.63), and anxiety/depression (APRs 0.46–0.68). Associations remained after adjustment for potential socio-demographic and behavioural confounders. ConclusionsWhile participation in own-bodyweight or gym-based-strength MSE is low, irrespective of mode, duration or volume, MSE was associated with a lower prevalence of chronic health conditions. Studies with longitudinal study designs are needed to confirm these cross-sectional findings.

Longitudinal trends and predictors of muscle-strengthening activity guideline adherence among Canadian youths

ObjectivesMuscle-strengthening activity (MSE e.g. push-ups, sit-ups, use of weight machines) is linked to multiple health benefits for youth, and is part of the global physical activity guidelines for children and adolescents (5–17 years). However, MSE is rarely assessed in youth health surveillance. This study describes the longitudinal trends and predictors of MSE among a cohort of Canadian youths. DesignLongitudinal. MethodsData were drawn from a cohort of 3366 youths who participated in three waves of COMPASS, a longitudinal study of secondary school students across Canada [Wave 1 (T1) 2015/16, Wave 2 (T2) 2016/17, Wave 3 (T3) 2018/19]. The prevalence of the sample meeting the MSE guideline (≥3 days/week) was calculated for each wave. A multivariable logistic regression assessed the odds of meeting the MSE guideline for each wave (T1 and T2 and T3) across sociodemographic/lifestyle characteristics (e.g. sex, race, regionally, Body Mass Index, and aerobic physical activity). ResultsFor the total sample, MSE guideline adherence significantly declined across each study wave (T1 = 57.0%; T2 = 52.0%; T3 = 48.5%; p < 0.001 for linear trend). Population sub-groups less likely to meet the guideline at each wave included females, youth who were underweight or obese, those reporting insufficient aerobic physical activity, those from large urban settings, and youth who identify as Asian. ConclusionsAmong a large sample of Canadian youths, approximately half met the MSE guideline, with this prevalence declining over time. Large-scale MSE interventions are needed to address the low and decreasing adherence to this key modifiable health-related behavior among Canadian youths.

Physical Activity and Public Health: Four Decades of Progress

Over the past 40 years, physical activity (PA) and public health has been established as a field of study. A robust evidence base has emerged demonstrating that participation in recommended amounts of PA results in a wide array of physical and mental health benefits. This led to the establishment of federal and global PA guidelines and surveillance programs. Strong evidence supports the efficacy of individual-level (e.g., goal setting) and environmental (e.g., policies) interventions to promote PA. There has also been progress in establishing a skilled and diverse workforce to execute the work of PA and public health. Looking forward, major challenges include stemming the obesity and chronic disease epidemics, addressing health inequities, and diversifying the workforce. Given the known benefits of PA and the availability of evidence-based interventions, efforts now must focus on implementing this knowledge to improve population health and reduce inequities through PA.

Commentary on "The First Global Physical Activity and Sedentary Behavior Guidelines for People Living With Disability".

Commentary on "The First Global Physical Activity and Sedentary Behavior Guidelines for People Living With Disability".

Response to "Commentary on: The First Global Physical Activity and Sedentary Behavior Guidelines for People Living With Disability".

Response to "Commentary on: The First Global Physical Activity and Sedentary Behavior Guidelines for People Living With Disability".

The First Global Physical Activity and Sedentary Behavior Guidelines for People Living With Disability.

The World Health Organization has released the first global public health guidelines on physical activity and sedentary behavior for people living with disability. This paper presents the guidelines, related processes, and evidence, and elaborates upon how the guidelines can support inclusive policy, practice, and research. Methods were consistent with the World Health Organization protocols for developing guidelines. Systematic reviews of the evidence on physical activity for health for people living with disability were appraised, along with a consideration of the evidence used to inform the general 2020 World Health Organization guidelines. Evidence supported the development of recommendations for people living with disability, stressing that there are no major risks to engaging in physical activity appropriate to an individual's current activity level, health status, and physical function, and that the health benefits accrued generally outweigh the risks. They also emphasize the benefits of limiting sedentary behavior. The guidelines mark a positive step forward for disability inclusion, but considerable effort is needed to advance the agenda. This paper highlights key considerations for the implementation of the new recommendations for people living with disability, in line with the human rights agenda underpinning the Global Action Plan on Physical Activity 2018-2030 and allied policies.

Inequality in physical activity, global trends by income inequality and gender in adults

BackgroundPhysical inactivity is a global pandemic associated with a high burden of disease and premature mortality. There is also a trend in growing economic inequalities which impacts population health. There is no global analysis of the relationship between income inequality and population levels of physical inactivity.MethodsTwo thousand sixteen World Health Organisation’s country level data about compliance with the 2010 global physical activity guidelines were analysed against country level income interquantile ratio data obtained from the World Bank, OECD and World Income Inequality Database. The analysis was stratified by country income (Low, Middle and High) according to the World Bank classification and gender. Multiple regression was used to quantify the association between physical activity and income inequality. Models were adjusted for GDP and percentage of GDP spent on health care for each country and out of pocket health care spent.ResultsSignificantly higher levels of inactivity and a wider gap between the percentage of women and men meeting global physical activity guidelines were found in countries with higher income inequality in high and middle income countries irrespective of a country wealth and spend on health care. For example, in higher income countries, for each point increase in the interquantile ratio data, levels of inactivity in women were 3.73% (CI 0.89 6.57) higher, levels of inactivity in men were 2.04% (CI 0.08 4.15) higher and the gap in inactivity levels between women and men was 1.50% larger (CI 0.16 2.83). Similar relationships were found in middle income countries with lower effect sizes. These relationships were, however, not demonstrated in the low-income countries.ConclusionsEconomic inequalities, particularly in high- and middle- income countries might contribute to physical inactivity and might be an important factor to consider and address in order to combat the global inactivity pandemic and to achieve the World Health Organisation target for inactivity reduction.

The epidemiology of muscle-strengthening exercise in Europe: A 28-country comparison including 280,605 adults.

ObjectiveMuscle-strengthening exercise (use of weight machines, free weights, push-ups, sit-ups), has multiple independent health benefits, and is a component of the Global physical activity guidelines. However, there is currently a lack of multi-country muscle-strengthening exercise prevalence studies. This study describes the prevalence and correlates of muscle-strengthening exercise across multiple European countries.MethodsData were drawn from the European Health Interview Survey Wave 2 (2013–14), which included nationally representative samples (n = 3,774–24,016) from 28 European countries. Muscle-strengthening exercise was assessed using the European Health Interview Survey Physical Activity Questionnaire. Population-weighted proportions were calculated for (1) “insufficient” (0–1 days/week) or (2) “sufficient” muscle-strengthening exercise (≥2 days/week). Prevalence ratios were calculated using multivariate Poisson regression for those reporting sufficient muscle-strengthening by country and by sociodemographic/lifestyle characteristics (sex, age, education, income, self-rated health etc.).ResultsData were available for 280,605 European adults aged ≥18 years. Overall, 17.3% (95% CI = 17.1%-17.5%) reported sufficient muscle-strengthening exercise (≥2 days/week). Muscle-strengthening exercise was geographically patterned with the lowest prevalence reported in South-eastern European countries (Romania, Malta and Cyprus: range: 0.7%-7.4%), and the highest prevalence in the Nordic countries (Iceland, Sweden, and Denmark: range: 34.1%-51.6%). Older age, insufficient aerobic activity, poorer self-rated health, lower income/education, being female, and being overweight/obese were significantly associated with lower likelihood of reporting sufficient muscle-strengthening exercise, independently of other characteristics.ConclusionsMost European adults do not report sufficient muscle-strengthening exercise, and prevalence estimates varied considerably across countries. Low participation in muscle-strengthening exercise is widespread across Europe, and warrants public health attention.

Motor Competence and Attainment of Global Physical Activity Guidelines among a Statewide Sample of Preschoolers.

Global physical activity guidelines for preschoolers include 60 min of moderate-to-vigorous physical activity (MVPA) daily. This study, based on the developmental model of motor skill competence, examines how motor competence relates to preschoolers’ likelihood of meeting global guidelines using ankle accelerometry. We measured physical activity using 24-h ankle-placement accelerometry (Actical) for at least two consecutive days (87% with six-seven days), motor competence using the Test of Gross Motor Development-2 (TGMD-2), and BMI-for-age z-scores (BMIz) using anthropometry and age- and sex-specific CDC norms. Caregivers provided demographic characteristics of children’s age, sex, and race. We used multivariable logistic regression to examine how motor competence, BMIz weight status, and demographic characteristics related to meeting global physical activity guidelines. The sample included 588 preschoolers, age 3–5 years; 55% male; 60% white; and 28% overweight/obese; 75% attained the recommended 60 min of MVPA per day. The odds of meeting MVPA guidelines were associated with higher gross motor quotient, higher object control scores, sex (male), age (older), and race (white), but not with BMIz weight status. Findings support the use of 24-h ankle accelerometry among preschoolers and are consistent with the developmental model of motor competence applied to preschoolers, whereby object control competence relates positively to attaining global physical activity guidelines.

The Effects of Strength and Conditioning in Physical Education on Athletic Motor Skill Competencies and Psychological Attributes of Secondary School Children: A Pilot Study.

Leading global physical activity guidelines advocate that young children need to engage in activities that strengthen musculoskeletal tissues and improve movement skill competency. The purpose of this study was to examine the effects of delivering strength and conditioning as part of the physical education curriculum on athletic motor skill competencies (AMSC), physical performance, and psychosocial factors. Forty-six school children aged 11–14 were included in the study, and sub-divided firstly by sex and then into intervention and control groups. Intervention groups received nine lessons of strength and conditioning based activities over a six-week period, while the control groups continued with traditional physical education curricula. The resistance training skills battery (RTSB) and tuck jump assessment (TJA) assessed AMSC. Standing long jump distance assessed lower limb strength, and online surveys examined motivation, physical self-efficacy and self-esteem. Male and female intervention groups significantly improved RTSB (p > 0.05) whereas no changes were observed in the control groups. No changes were observed in the intervention groups TJA and only trivial and small non-significant changes in standing long jump performance. Significant increases in motivation of the male intervention group occurred. Strength and conditioning integrated in physical education can improve AMSC in short-term interventions.

Tummy Time and Infant Health Outcomes: A Systematic Review.

The World Health Organization recommends tummy time for infants because of the benefits of improved motor development and reduced likelihood of plagiocephaly. Because of poor uptake of these recommendations, the association of tummy time with other health outcomes requires further investigation. To review existing evidence regarding the association of tummy time with a broad and specific range of infant health outcomes. Electronic databases were searched between June 2018 and April 2019. Peer-reviewed English-language articles were included if they investigated a population of healthy infants (0 to 12 months), using an observational or experimental study design containing an objective or subjective measure of tummy time which examined the association with a health outcome (adiposity, motor development, psychosocial health, cognitive development, fitness, cardiometabolic health, or risks/harms). Two reviewers independently extracted data and assessed their quality. Sixteen articles representing 4237 participants from 8 countries were included. Tummy time was positively associated with gross motor and total development, a reduction in the BMI-z score, prevention of brachycephaly, and the ability to move while prone, supine, crawling, and rolling. An indeterminate association was found for social and cognitive domains, plagiocephaly, walking, standing, and sitting. No association was found for fine motor development and communication. Most studies were observational in design and lacked the robustness of a randomized controlled trial. High selection and performance bias were also present. These findings guide the prioritization of interventions aimed at assisting parents meet the global and national physical activity guidelines.

Associations between utilitarian walking, meeting global physical activity guidelines, and psychological well-being among South Korean adolescents

IntroductionThis study examined the levels of utilitarian walking by age and gender and associations between utilitarian walking, meeting global physical activity guidelines, and psychological well-being in a nationally representative sample of South Korean adolescents. MethodsThe 2016 Korea Youth Risk Behavior Web-based Survey included complete self-reported data from 60,548 adolescents aged 12–17 years (M age = 14.8 ± .02). Utilitarian walking was the exposure variable and outcome variables included meeting the World Health Organization's moderate-to-vigorous physical activity (MVPA) recommendation (≥60 min/day), happiness, and stress. Covariates included age, gender, area of residence, economic status, and academic performance. The Complex Samples (CS) general linear and logistic regression analyses were conducted. ResultsA significant age x gender interaction was observed on weekly utilitarian walking. Boys showed higher utilitarian walking than girls (5.8 vs. 5.1 h/wk; p < .001). The age differences were more apparent among girls with younger age generally showing higher utilitarian walking than older age except 12 vs. 13 years (p < .001). Among boys, age differences were only observed for 12 vs. 13 years and 13 vs. 14 years (p < .001). Weekly utilitarian walking for 1–5 h (Odds ratio[OR]: 1.73, 95%Confidence interval[CI]: 1.41–2.13) and >5 h (OR: 5.26, 95%CI: 4.32–6.41), compared to <1 h, were associated with meeting the MVPA recommendation (p-for-trend< .001). Compared to adolescents who reported <1 h/wk on utilitarian walking, those reporting 1–5 h/wk (OR: 1.18, 95%CI: 1.12–1.25) and > 5 h/wk (OR: 1.29, 95%CI: 1.22–1.37) were associated with higher odds of being happy in a linear fashion (p-for-trend< 0.001) after adjusting for MVPA in addition to covariates. No associations were observed between utilitarian walking and no/low stress. ConclusionHigher levels of utilitarian walking were associated with meeting the MVPA recommendation and being happy. Future studies should investigate the correlates of utilitarian walking to inform interventions and strategies to promote such walking among Korean adolescents.