Moderate Physical Activity Recommendations Research Articles

Changes in self-reported and accelerometer-measured physical activity among pregnant TRICARE Beneficiaries

BackgroundPhysical activity is recommended for all pregnant individuals and can prevent excessive gestational weight gain. However, physical activity has not been assessed among military personnel and other TRICARE beneficiaries, who experience unique military lifestyles. The current study assessed physical activity among pregnant TRICARE beneficiaries, both active duty and non-active duty, as measured by accelerometry and self-report data to examine potential predictors of physical activity engagement in the third trimester, and if self-report data was consistent with accelerometry data. We expected having a lower BMI, being active-duty, and having higher baseline physical activity engagement to be associated with higher physical activity at 32-weeks. We also hypothesized that accelerometry data would show lower physical activity levels than the self-reported measure.MethodsParticipants were 430 TRICARE adult beneficiaries (204 Active Duty; 226 non-Active Duty) in San Antonio, TX who were part of a randomized controlled parent study that implemented a stepped-care behavioral intervention. Participants were recruited if they were less than 12-weeks gestation and did not have health conditions precluding dietary or physical activity changes (e.g., uncontrolled cardiovascular conditions) or would contribute to weight changes. Participants completed self-report measures and wore an Actical Activity Monitor accelerometer on their wrist to collect physical activity data at baseline and 32-weeks gestation.ResultsBased on the accelerometer data, 99% of participants were meeting moderate physical activity guidelines recommending 150 min of moderate activity per week at baseline, and 96% were meeting this recommendation at 32-weeks. Based on self-report data, 88% of participants at baseline and 92% at 32-weeks met moderate physical activity recommendations. Linear regression and zero-inflated negative binomial models indicated that baseline physical activity engagement predicted moderate physical activity later in pregnancy above and beyond BMI and military status. Surprisingly, self-reported data, but not accelerometer data, showed that higher baseline activity was associated with decreased vigorous activity at 32-weeks gestation. Additionally, self-report and accelerometry data had small correlations at baseline, but not at 32-weeks.ConclusionsFuture intervention efforts may benefit from intervening with individuals with lower pre-pregnancy activity levels, as those who are active seem to continue this habit.Trial RegistrationThe trial is registered on clinicaltrials.gov (NCT 03057808).

영과잉 음이항 회귀모형을 적용한 농촌지역 성인 신체활동의 지역사회환경 요인 분석

Purpose: This study was conducted to determine the neighborhood environmental factors associated with physical activity among adults living in rural communities. Methods: A cross-sectional descriptive survey was conducted with a convenience sample of 201 adults living in three Ri in Y-city, Gyeonggi-do. Data were collected from face-to-face interview by trained interviewers and were analyzed using a zero-inflated negative binominal regression model. Results: Participants reported engaged in moderate or vigorous physical activity was 76.1%; 10.5% of participants reported that they met moderate physical activity recommendations and 14.5% of participants reported that they met vigorous physical activity recommendations. Zero-inflated negative binominal regression analysis showed association of increasing days of physical activity with social cohesion (<TEX>${\beta}=.130$</TEX>, p=.005), social network (<TEX>${\beta}=-.096$</TEX>, p=.003), and safety for crime (<TEX>${\beta}=-.151$</TEX>, p=.036), and no days of physical activity was associated with no attainment of education and marginally associated with increasing BMI. Conclusion: Neighborhood environmental factors including social cohesion, social network, and crime for safety were significantly associated with physical activity of rural adults. Community health nurses should expand an approach for individual behavior change to incorporate rural adults' specific neighborhood environmental factors into physical activity interventions.

Correlates of walking for transportation and use of public transportation among adults in St Louis, Missouri, 2012.

IntroductionAttributes of the built environment can influence active transportation, including use of public transportation. However, the relationship between perceptions of the built environment and use of public transportation deserves further attention. The objectives of this study were 1) to assess the relationship between personal characteristics and public transportation use with meeting national recommendations for moderate physical activity through walking for transportation and 2) to examine associations between personal and perceived environmental factors and frequency of public transportation use.MethodsIn 2012, we administered a mail-based survey to 772 adults in St Louis, Missouri, to assess perceptions of the built environment, physical activity, and transportation behaviors. The abbreviated International Physical Activity Questionnaire was used to assess walking for transportation and use of public transportation. The Neighborhood Environment Walkability Scale was used to examine perceptions of the built environment. Associations were assessed by using multinomial logistic regression.ResultsPeople who used public transportation at least once in the previous week were more likely to meet moderate physical activity recommendations by walking for transportation. Age and employment were significantly associated with public transportation use. Perceptions of high traffic speed and high crime were negatively associated with public transportation use.ConclusionOur results were consistent with previous research suggesting that public transportation use is related to walking for transportation. More importantly, our study suggests that perceptions of traffic speed and crime are related to frequency of public transportation use. Future interventions to encourage public transportation use should consider policy and planning decisions that reduce traffic speed and improve safety.

Benefits of achieving vigorous as well as moderate physical activity recommendations: Evidence from heart rate complexity and cardiac vagal modulation

The aim of this study was to examine differences in traditional heart rate variability measurements and heart rate complexity (sample entropy) in young adults grouped by objectively measured achievement of either moderate or both moderate and vigorous physical activity recommendations. Of 168 young adults tested (86 females, 82 males; age 20.5 ± 1.2 years), 119 achieved only recommendations for moderate physical activity (moderate group) and 49 achieved recommendations for both moderate and vigorous physical activity (vigorous group). Analysis of covariance controlling for sex, weekly minutes of moderate physical activity, and percentage of body fat was used to assess between-group differences in heart rate variability and heart rate complexity. Logistic regression analysis was used to determine the group characteristics that best predicted high heart rate complexity and vagal indices of heart rate variability. The majority of the autonomic measures were higher (P < 0.05) in the vigorous group, and regression analysis showed that vigorous physical activity was the only multivariate predictor of higher heart rate complexity and higher heart rate variability. Young adults engaged in regular vigorous physical activity were more than twice as likely to have high heart rate complexity than those involved in predominantly moderate exercise. These findings suggest that vigorous physical activity is more closely associated with high heart rate complexity than moderate physical activity in young adults.

Physical Activity Behaviors of Students of a Rural Historically Black College

Physical activity can have a positive impact on health disparities among African Americans. Objective: In this study, we assessed physical activity behaviors and correlates of students of a Historically Black College. Methods: In September 2004, an online survey and pedometers were used to measure physical activity behavior and correlates. Participants: A convenience sample of 106 students completed the survey and received pedometers. Pedometer data were submitted online for 5 weeks. Results: One hundred and six students completed the survey. Twenty-eight percent and 41% of respondents met recommendations for moderate physical activity and vigorous physical activity, respectively. Week 1 daily pedometer step count average was 8,707. Most students reported positive outcome expectations for physical activity. Students submitting pedometer data were less likely to meet MPA recommendations than students only completing the survey. Conclusions: African American students feel positive about physical activity yet most do not meet recommended levels.

Maintenance of physical activity after Internet-based physical activity interventions in patients with rheumatoid arthritis

To investigate the maintenance of physical activity 12 months after two 1-year Internet-based physical activity interventions in patients with RA. This follow-up study was a randomized comparison of an Internet-based individualized training (IT) and a general training (GT) programme in sedentary RA patients. Outcome measures included physical activity (meeting public health recommendations for moderate physical activity, i.e. 30 min for at least 5 days/week; or vigorous physical activity, i.e. 20 min for at least 3 days/week), functional ability and quality of life (QoL). Of the 152 RA patients who completed the initial study, 110 (72%) were available at follow-up. At 24 months, the proportions of patients meeting public health recommendations for moderate intensity physical activity were significantly higher compared with baseline in both the IT and GT groups (19 and 24%, respectively, P < 0.05), whereas the proportions of patients meeting the recommendation for vigorous activity was only significantly higher compared with baseline in the IT group (P < 0.05) but not in the GT group. There were no differences between the IT and GT groups concerning proportions of patients meeting moderate or vigorous physical activity recommendations at 24 months. Apart from a significantly higher RAQoL score in the IT group at 24 months compared with baseline, there were no significant differences within or between the programmes regarding functional ability or QoL. In RA patients, the effectiveness of both an individualized and a general 1-year Internet-based physical activity programme is sustained with respect to moderate intensity physical activity up to 12 months after the interventions.

Vigorous and Moderate Physical Activity among U.S. Adults—A Reaction to Seo and Torabi

Physical inactivity is a major public health issue in this country. The majority of adults do not engage in recommended amounts of physical activity, is on the rise, and health care costs for diseases associated with a sedentary lifestyle continue to skyrocket. Given the numerous health benefits that can be obtained by engaging in regular physical activity, many health education and promotion professionals are planning, refining, and implementing physical activity interventions for individuals and communities. Understanding the various correlates of physical activity is a necessary prerequisite for developing physical activity interventions. In a study discussed in this issue of the journal, Seo and Torabi examined several demographic correlates of moderate and vigorous physical activity in adults. Specifically, they analyzed correlates of moderate and vigorous physical activity separately, which makes a valuable contribution to the physical activity correlates literature. Previously, the majority of correlate studies used physical activity or exercise during leisure time as the dependent variable and did not address activity intensity. (1) In their study, Seo and Torabi found that age, gender, race, income, and education were independent predictors of vigorous physical activity. These demographic correlates of vigorous physical activity are similar to those reported by Trost and colleagues (1) in their comprehensive review of adult physical activity correlate studies. When discussing the results of their study, Seo and Torabi state, has not been clearly shown that increased moderate PA (i.e., meeting the moderate guideline on 5 days or more) leads to reduced body (p127). Health education and promotion professionals should consider the desired outcome of a physical activity intervention when deciding which recommendation to endorse. If general health benefits are desired, the moderate physical activity recommendation (2) of at least 30 minutes per day on most ([greater than or equal to] 5) days of the week would be appropriate because it was developed as a public health recommendation that, if followed, would reduce morbidity and mortality from chronic diseases, particularly among sedentary adults. (3) If, however, the desired outcome of the intervention is weight loss or the prevention of weight gain, then health professionals should promote the Institute of Medicine recommendation of 60 minutes of daily moderate-intensity physical activity (4) or the Dietary Guidelines for Americans recommendation of at least 60 minutes of moderate-to-vigorous physical activity most days of the week. (5) Further more, dietary modification to control caloric intake is also advised if weight loss is the goal of the intervention. (5) Seo and Torabi encourage health education and promotion professionals to put more emphasis on vigorous PA than moderate, especially to help halt the increasing trend of obesity (p127). They also state that added emphasis on vigorous activity seems justifiable, as an equal amount of energy expenditure can be attained faster through vigorous-intensity activity than moderate-intensity activity (although it should be noted that vigorous activity is associated with higher risks for injuries, especially among the elderly) (p127). While I agree with the authors that increased intensity leads to additional caloric expenditure, I strongly encourage health education and promotion professionals to carefully consider all components of physical activity (frequency, intensity, duration, and mode), the desired outcome of the intervention, the target population, and participants' baseline activity levels when deciding the appropriate intensity to promote. A unique finding of Seo and Torabi's study was that Hispanics were more likely than Whites to meet the moderate physical activity recommendation of at least 30 minutes per day on most ([greater than or equal to] 5) days of the week. …

Barriers to Physical Activity Among Women in the Rural Midwest

ABSTRACT Physical activity is an important factor in chronic disease control and prevention. Yet women and rural residents consistently report lower rates of physical activity than their male and urban/suburban counterparts. The objective of this study was to assess the relationship between personal, social, and environmental barriers and meeting moderate physical activity recommendations in a sample of rural women. Data were obtained from a telephone survey of 2,510 residents of rural southeastern Missouri, Tennessee, and Arkansas. After adjusting for age and income, women who identified personal barriers, such as lack of time, no motivation, disinterest in exercise, and having no one to exercise with were less likely to meet physical activity recommendations. There was evidence of a dose-response relationship between the number of barriers identified and meeting moderate physical activity recommendations among women with higher incomes and women with lower incomes; however, this relationship was most striking among women with annual household incomes of $25,000 or more. These findings may be used to tailor physical activity interventions to women in rural communities.

Accelerometer-Determined Physical Activity of Free-Living College Students

This study was conducted to provide descriptive data of accelerometer-determined ambulatory physical activity in a sample of free-living college students and to examine college students' ambulatory physical activity patterns. All participants (245 females, age = 19.9 +/- 1.6 yr, body mass index (BMI) = 22.9 +/- 3.3 kg x m(-2); 209 males, age = 20.2 +/- 2.0 yr, BMI = 25.2 +/- 4.0 kg x m(-2)) wore an accelerometer for seven consecutive days. Accumulated physical activity (ct.d, ct x min(-1) x d(-1), and min x d(-1) spent at different intensities) and minutes per day spent in moderate or vigorous physical activity in sessions of at least 10 min were analyzed to describe the physical activity of the sample and examine physical activity patterns. The entire sample accumulated 362,750.1 +/- 112,824.1 ct x d(-1) (males = 383,787.2 +/- 112,001.3 vs females = 344,804.1 +/- 110,619.5 ct x d(-1), P < 0.01) and 46.7 +/- 18.9 min x d(-1) in moderate physical activity (males = 51.7 +/- 19.8 vs females = 42.5 +/- 17.0 min x d(-1), P < 0.01). They were more active on weekdays than weekend days (P < 0.05), and they spent 13.6 +/- 12.7 min x d(-1) (males = 13.2 +/- 12.0 vs females = 13.8 +/- 13.3, P > 0.05) in moderate or vigorous physical activity sessions of at least 10 min. Participants in this study accumulated a moderate amount of physical activity on most weekdays. Most participants, however, were not meeting the current moderate physical activity recommendation when moderate or vigorous physical activity sessions of at least 10 min were examined.

Correlates of Physical Activity among Pregnant Women in the United States

Physical activity recommendations for pregnant and nonpregnant women have been issued, but little data exist to compare the extent that these women are meeting the recommendation levels. A population-based, cross-sectional study using data from the 1994, 1996, 1998, and 2000 Behavioral Risk Factor Surveillance System evaluated the physical activity recommendations met by pregnant and nonpregnant women. The study population included women who were 18-44 yr of age. Random digit dialing, telephone surveys were used to assess all information. Pregnant and nonpregnant women were categorized into five mutually exclusive groups based upon their level of physical activity in the past month: vigorous activity (meeting guidelines) moderate activity (meeting guidelines), moderate or vigorous activity (not meeting guidelines), irregular activity, or no physical activity. Nonpregnant women were more likely than pregnant women to meet the vigorous or moderate physical activity recommendations. Walking was the most common activity among pregnant and nonpregnant women (52 and 45%, respectively). Pregnant women meeting the moderate or vigorous physical activity recommendations were more likely to be younger, nonhispanic white, more educated, not married, nonsmokers, and to have higher incomes. Many pregnant women do not appear to be meeting the physical activity recommendations. Healthcare providers should further encourage the promotion of physical activity during uncomplicated pregnancies.

Relationship Between Objectively Measured Steps and Time Spent in Physical Activity Among Free-Living College Students

The purposes of this study were to examine the relationship between steps·day-1 and time spent in physical activity, and to identify the number of steps·day-1 that corresponded to 30 min or more of moderate physical activity (MPA). Thirty-six college students (age: 23.3 ± 3.1 years; body mass index [BMI]: 25.5 ± 4.1 kg·m-2 ) concurrently wore a pedometer and an accelerometer during all waking hours for 7 consecutive days. Participants averaged 9,940.4 ± 2,867.1 steps·day-1 . The correlation coefficients between steps·day-1 and time spent in the different physical activity categories were all significant, with the relationship between steps·day-1 and time spent in MPA being the strongest, r = .69 (95% confidence interval [CI]: 0.53, 0.86), p < .0001. Results indicated that those students meeting the MPA recommendation accumulated 11,821.87 ± 2,682.31 steps·day-1 . Future researchers should examine the relationship between steps·day-1 and time spent in physical activity using larger and more heterogeneous samples to examine the efficacy of these findings.

Maternal Physical Activity And Birth Weight

The CDC/ACSM (1995) recommendations for moderate physical activity (PA) (3–5 METs, ≥30 min, ≥5 d·wk−1) in healthy adults are currently advocated for pregnant women by the American College of Obstetricians and Gynecologists (ACOG, 2002). However, further research on birth outcome may be needed before ACOG endorses theCDC/ACSM recommendations for vigorous PA (≥ 6 METs, ≥20 min, ≥3 d·wk−1) during pregnancy. PURPOSE Using meta-analysis, we examined whether the relationship between maternal PA and birth weight was moderated by PA intensity. Additionally we examined the impact of maternal weight gain on birth weight. METHODS The literature search was performed using NLM Medline, Embase, and manual searching of bibliographies. Studies were screened to ensure they included a measure of physical activity during pregnancy (with a sedentary control group) and reported birth weight as a continuous variable within the normal birth weight range. A random effects model was used to calculate the pooled effect size (ES) of birth weight by maternal PA. Pre-specified subgroups (e.g., maternal age, maternal weight gain, study design) were used to examine potential heterogeneity. Meta-regression was utilized to estimate the amount of variance in birth weight between physically active and sedentary pregnant women that can be accounted for by differences in maternal weight gain. RESULTS Of 2418 potentially relevant studies located, 23 satisfied inclusion criteria after full-text review. Study participants were mostly Caucasian, nonsmokers, and nulliparous. Significant heterogeneity was found between PA and birth weight across all studies (P<0.01). In subgroup analyses, moderate PA was not significantly related to birth weight (ES=0.05; P=0.49). There was evidence of a negative relationship between vigorous PA and birth weight (ES=0.27; P<0.01) (∼150 g difference); however, significant heterogeneity precludes further interpretation, i.e., the studies included in this subgroup were too disparate to compare. Differences in maternal weight gain significantly and positively accounted for ∼17% of the variance in birth weight between moderate and vigorous exercisers (P<0.01). CONCLUSIONS Moderate physical activity performed throughout pregnancy did not affect birth weight. The impact of vigorous PA on birth weight remains unclear due to significant heterogeneity of study results.

Maternal Physical Activity And Birth Weight

The CDC/ACSM (1995) recommendations for moderate physical activity (PA) (3–5 METs, ≥30 min, ≥5 d·wk−1) in healthy adults are currently advocated for pregnant women by the American College of Obstetricians and Gynecologists (ACOG, 2002). However, further research on birth outcome may be needed before ACOG endorses theCDC/ACSM recommendations for vigorous PA (≥ 6 METs, ≥20 min, ≥3 d·wk−1) during pregnancy. PURPOSE Using meta-analysis, we examined whether the relationship between maternal PA and birth weight was moderated by PA intensity. Additionally we examined the impact of maternal weight gain on birth weight. METHODS The literature search was performed using NLM Medline, Embase, and manual searching of bibliographies. Studies were screened to ensure they included a measure of physical activity during pregnancy (with a sedentary control group) and reported birth weight as a continuous variable within the normal birth weight range. A random effects model was used to calculate the pooled effect size (ES) of birth weight by maternal PA. Pre-specified subgroups (e.g., maternal age, maternal weight gain, study design) were used to examine potential heterogeneity. Meta-regression was utilized to estimate the amount of variance in birth weight between physically active and sedentary pregnant women that can be accounted for by differences in maternal weight gain. RESULTS Of 2418 potentially relevant studies located, 23 satisfied inclusion criteria after full-text review. Study participants were mostly Caucasian, nonsmokers, and nulliparous. Significant heterogeneity was found between PA and birth weight across all studies (P<0.01). In subgroup analyses, moderate PA was not significantly related to birth weight (ES=0.05; P=0.49). There was evidence of a negative relationship between vigorous PA and birth weight (ES=0.27; P<0.01) (∼150 g difference); however, significant heterogeneity precludes further interpretation, i.e., the studies included in this subgroup were too disparate to compare. Differences in maternal weight gain significantly and positively accounted for ∼17% of the variance in birth weight between moderate and vigorous exercisers (P<0.01). CONCLUSIONS Moderate physical activity performed throughout pregnancy did not affect birth weight. The impact of vigorous PA on birth weight remains unclear due to significant heterogeneity of study results.

NATIONAL-LEVEL PROMOTION OF PHYSICAL ACTIVITY

Objectives To assess the impact of a national campaign on awareness of the campaign, change in knowledge of physical activity recommendations and self reported physical activity. Setting England Design 3-year prospective longitudinal survey using a multi-stage, cluster random probability design to select participants. Participants A nationally representative sample of 3,189 adults aged 16–74 years. Main outcome measures Awareness of the advertising element of the campaign, changes in knowledge of physical activity recommendations for health and self reported physical activity. Results 38% of participants were aware of the main advertising images, assessed 6–8 months after the main television advertisement. The proportion of participants knowledgeable about moderate physical activity recommendations increased by 3.0% (95% CI: 1.4, 4.5) between waves 1 and 2 and 3.7% (95% CI: 2.1, 5.3) between waves 1 and 3. The change in proportion of active people between baseline and waves 1 and 2 was 0.02% (95% CI: −2.0 to + 1.7) and between waves 1 and 3 was −9.8% (−7.9 to −11.7). Conclusion The proportion of participants who were knowledgeable about the new recommendations, increased significantly following the campaign. There was however, no significant difference in knowledge by awareness of the main campaign advertisement. There is no evidence that ACTIVE for LIFE improved physical activity, either overall or in any subgroup. Supported by a grant from the DoH.

Moderate leisure-time physical activity: who is meeting the public health recommendations? A national cross-sectional study.

We identified the prevalence of adults who met the 1993 Centers for Disease Control and Prevention and the American College of Sports Medicine moderate physical activity recommendation and the 1996 Surgeon General's Report on Physical Activity and Health energy expenditure guideline for leading a moderately active lifestyle. Participants were 16,890 women and 12,272 men at least 18 years old who were asked in the 1990 National Health Interview Survey about their leisure-time physical activities. About one third of US adults met either recommendation for moderate activity; 32% met the Centers for Disease Control and Prevention and the American Association of Sports Medicine recommendation and 38% met the surgeon general's guideline. Women, ethnic minorities, adults with lower educational attainment, and older adults were least active. Public health efforts are needed to address the issues related to physical inactivity and to provide organized programs to increase moderate physical activity levels in US adults.