Physical activity assessment in population surveys: can it really be simplified?
BACKGROUND: Several studies have used a simplified approach for the assessment of physical activity such as the frequency of exercise-induced sweating. In this study leisure-time physical activity has been assessed using this and another more detailed measure. SUBJECTS AND METHODS: A sample of 4171 adults answered the Health Interview Survey of Barcelona in 1992. The respondents were classified into categories depending on participation in moderate and/or intense physical activity (> or =20 min) and also according to the frequency of exercise-induced sweating: 0, 1-2 and > or =3 times/week. Agreement between the two measures was calculated using the weighted Kappa (Kw) statistic with 95% confidence intervals (95% CI). Stratified analyses were performed. RESULTS: Prevalence of physical activity > or =3 times/week was lower with the sweat question (12.5%) than with the questions about the frequency of performance of selected activities (19.6%). The physical activity patterns by age, gender and overweight were similar for the two measures, but differed by month of the year. Agreement was lower among the older age categories and was higher among males (Kw = 0.59, 95% CI: 0.57-0.62) than among females (Kw = 0.48, 95% CI: 0.46-0.50). Overall, the agreement was higher in the hotter months (Kw = 0.72 among males and 0.58 among females). CONCLUSIONS: In the assessment of physical activity in the population by means of the sweat question there can be interference from other variables, apart from the intensity of the activity, which influence sweating during the exercise. Further assessments of the validity of exercise-induced sweating in representative samples of the general population would be useful. (+info)
The impact of smoking, alcohol consumption, and physical activity on use of hospital services.
OBJECTIVES: This study investigated the associations of smoking, excess alcohol consumption, and physical inactivity with the use of hospital care. METHODS: A cohort of 19- to 63-year-old Finnish men (n = 2534) and women (n = 2668) were followed prospectively for 16 years. Number of hospital days was extracted from the national hospital discharge registry, while data concerning exposure variables were derived from the baseline questionnaire. RESULTS: After adjustment for confounders, male smokers had 70% (95% confidence interval [CI] = 49%, 95%) and female smokers had 49% (95% CI = 29%, 71%) more hospital days due to my cause than did those who had never smoked. Men consuming a moderate amount of alcohol had 21% (95% CI = 10%, 31%) fewer hospital days due to any cause than did nondrinkers. Men who had the lowest energy expenditure during leisure-time physical activity had 36% (95% CI = 15%, 63%) more hospital days than the most active men. The figure for women was 23% (95% CI = 4%, 44%). CONCLUSIONS: Smoking was strongly associated with an increased use of hospital services. The associations of alcohol consumption and leisure-time physical activity with use of hospital care depended on the diagnosis under study. (+info)
Health promotion for people with disabilities: the emerging paradigm shift from disability prevention to prevention of secondary conditions.
The premise of this article is that, until recently, health promotion for people with disabilities has been a neglected area of interest on the part of the general health community. Today, researchers, funding agencies, and health care providers and consumers are leading an effort to establish higher-quality health care for the millions of Americans with disabilities. The aims of a health promotion program for people with disabilities are to reduce secondary conditions (eg, obesity, hypertension, pressure sores), to maintain functional independence, to provide an opportunity for leisure and enjoyment, and to enhance the overall quality of life by reducing environmental barriers to good health. A greater emphasis must be placed on community-based health promotion initiatives for people with disabilities in order to achieve these objectives. (+info)
Definition and prevalence of sedentarism in an urban population.
OBJECTIVES: The present study sought to formulate a precise definition of sedentarism and to identify activities performed by active people that could serve as effective preventive goals. METHODS: A population-based sample of 919 residents of Geneva, Switzerland, aged 35 to 74 years, completed a 24-hour recall. Sedentary people were defined as those expending less than 10% of their daily energy in the performance of moderate- and high-intensity activities (at least 4 times the basal metabolism rate). RESULTS: The rates of sedentarism were 79.5% in men and 87.2% in women. Among sedentary and active men, average daily energy expenditures were 2600 kcal (95% confidence interval [CI] = 2552, 2648) and 3226 kcal (95% CI = 3110, 3346), respectively; the corresponding averages for women were 2092 kcal (95% CI = 2064, 2120) and 2356 kcal (95% CI = 2274, 2440). The main moderate- and high-intensity activities among active people were sports (tennis, gymnastics, skiing), walking, climbing stairs, gardening, and (for men only) occupational activities. CONCLUSIONS: The definition of sedentarism outlined in this article can be reproduced in other populations, allows comparisons across studies, and provides preventive guidelines in that the activities most frequently performed by active people are the ones most likely to be adopted by their sedentary peers. (+info)
Physical activity, body mass index, and prostaglandin E2 levels in rectal mucosa.
BACKGROUND: Evidence suggests a relationship between prostaglandin levels in colonic mucosa and risk of colon cancer. Physical inactivity and a higher body mass index (BMI; weight in kilograms divided by [height in meters]2) have been consistently shown to increase risk of this cancer. We investigated whether higher levels of leisure-time physical activity or a lower BMI was associated with lower concentrations of prostaglandin E2 (PGE2) in rectal mucosa. METHODS: This study was conducted in 41 men and 22 women, 42-78 years of age, with a history of polyps, who participated in a randomized clinical trial testing the effects of piroxicam on rectal mucosal PGE2 levels. An [125I]PGE2 radioimmunoassay kit was used to determine PGE2 levels in samples of extracted rectal mucosa collected before randomization. Leisure-time physical activity was assessed through a self-administered questionnaire collected at baseline. The reported time spent at each activity per week was multiplied by its typical energy expenditure, expressed in metabolic equivalents (METs), to yield a MET-hours per week score. A repeated measures model was used to assess the effect of BMI and physical activity as predictors of PGE2 concentration. All statistical tests were two-sided. RESULTS: After adjustment for age, a higher BMI was associated with higher PGE2 levels (P = .001). A higher level of leisure-time physical activity was inversely associated with PGE2 concentration (P<.03). An increase in BMI from 24.2 to 28.8 kg/m2 was associated with a 27% increase in PGE2. An increase in activity level from 5.2 to 27.7 MET-hours per week was associated with a 28% decrease in PGE2. CONCLUSIONS: Physical activity and obesity may alter the risk of colon cancer through their effects on PGE2 synthesis. (+info)
The impact of after-school peer contact on early adolescent externalizing problems is moderated by parental monitoring, perceived neighborhood safety, and prior adjustment.
Unsupervised peer contact in the after-school hours was examined as a risk factor in the development of externalizing problems in a longitudinal sample of early adolescents. Parental monitoring, neighborhood safety, and adolescents' preexisting behavioral problems were considered as possible moderators of the risk relation. Interviews with mothers provided information on monitoring, neighborhood safety, and demographics. Early adolescent (ages 12-13 years) after-school time use was assessed via a telephone interview in grade 6 (N = 438); amount of time spent with peers when no adult was present was tabulated. Teacher ratings of externalizing behavior problems were collected in grades 6 and 7. Unsupervised peer contact, lack of neighborhood safety, and low monitoring incrementally predicted grade 7 externalizing problems, after controlling for family background factors and grade 6 problems. The greatest risk was for those unsupervised adolescents living in low-monitoring homes and comparatively unsafe neighborhoods. The significant relation between unsupervised peer contact and problem behavior in grade 7 held only for those adolescents who already were high in problem behavior in grade 6. These findings point to the need to consider individual, family, and neighborhood factors in evaluating risks associated with young adolescents' after-school care experiences. (+info)
Socio-economic consequences of rheumatoid arthritis in the first years of the disease.
OBJECTIVE: Few data have been presented to document the impact of rheumatoid arthritis (RA) on socio-economic well-being. In this study, exact figures on socio-economic consequences were assessed. METHODS: The socio-economic consequences were studied in an inception cohort (186 early RA patients, mean disease duration 3 yr) by measuring the change in work capability, income, rest during the daytime, leisure time activity, transport mobility, housing and social support occurring in the first years of the disease. RESULTS: For 89% of the patients, RA had an impact on one of the socio-economic items; for 58%, at least three of these items were affected simultaneously. Work disability appeared to be 4-15 times higher than in the general population. After 3 yr, 42% of the patients were registered as work disabled. Nearly a quarter of the patients experienced income reduction. Over 40% of the patients claimed extra rest during the daytime. Leisure activity changed towards activities with a lower joint load. There was a decline in transport mobility for 52% of the patients. Social support increased strongly. CONCLUSIONS: Socio-economic change already presents in the first years of RA and appears to be influenced by age, gender, marital status and work disability. Furthermore, physical limitation appeared to be predictive for work-related income reduction, reduced transport mobility and development of social dependency. (+info)
Depressive symptoms and occurrence of type 2 diabetes among Japanese men.
OBJECTIVE: To examine the relationship between depressive symptoms and the incidence of type 2 diabetes. RESEARCH DESIGN AND METHODS: In 1984, 2,764 male employees of an electrical company in Japan completed a self-administered questionnaire including the Zung Self-Rating Depression Scale (SDS). They were followed for the next 8 years, and 2,380 (86%) responded to the follow-up survey in 1992. During the follow-up survey, occurrence of type 2 diabetes was diagnosed according to World Health Organization criteria. RESULTS: A total of 41 cases of type 2 diabetes were identified during the 8-year follow-up survey. After controlling for other known risk factors for type 2 diabetes, a proportional hazard analysis indicated that subjects who had moderate or severe levels of depressive symptoms (> or = 48 on the SDS) at baseline had a 2.3 times higher risk of having type 2 diabetes at the follow-up survey than those who were not depressed (< or = 39 on the SDS) (P < 0.05). CONCLUSIONS: Depressive symptoms may be associated with the onset of type 2 diabetes. (+info)