Assessment of physical activity among primary school aged children: the Children's Leisure Activities Study (CLASS)

Overweight and obesity rates among children in Australia have increased twofold in the last decade. Physical activity is thought to play an important role in the prevention and treatment of childhood obesity. Children's physical activity data in Australia are incomplete and mainly based on parental proxy reports. One of the reasons for the lack of children's physical activity prevalence data in Australia is the difficulties of measurement. The aim of this study was to develop and examine a reliable, valid and feasible method for assessing physical activity among primary school aged children. A total of 112 grade 5 and 6 children and their parents were recruited from four state primary schools in the eastern and western suburbs of Melbourne. The test-retest reliability of a parental proxy physical activity questionnaire and a children's self report physical activity questionnaire was assessed. The criterion validity of the questionnaires was assessed using accelerometry. Findings suggest that the self report and proxy report questionnaires provided reliable measures of the type, frequency and duration of children's physical activity behaviour. Overall, the criterion validity of the questionnaires was poor. Although accelerometry as an objective measure shows promise, it does not provide the important physical activity behavioural and contextual information that is critical for the development of strategies to promote physical activity among children. We recommend that a combination of self report or proxy and objective measurement (using accelerometry or even pedometry) appears to be the current 'best buy' in the assessment of children's physical activity behaviour.

Volume of physical activity and injury occurrence in young basketball players

Participation in organised, competitive physical activity by young athletes is increasing rapidly. This is concurrent with an increase in sporting injuries in the young population. This pilot study aimed to compare the weekly volume and types of physical activity in young basketball players injured and not injured during the season. Detailed physical activity and injury data were prospectively collected in 46 school-level basketball players aged 14 to 18 years. Participants completed physical activity logs which documented the type of physical activity undertaken, what the activity consisted of (i.e. training, competition) and the level at which it was played on a daily basis. Allied health staff completed a weekly injury form. Results showed that injured and uninjured athletes participated in a similar volume of total weekly physical activity over the season. However, injured athletes (p = 0.04) and athletes who specifically sustained overuse injuries (p = 0.01) participated in a greater amount of basketball refereeing than uninjured athletes. Based on these findings it was concluded that greater participation in running-type physical activity such as refereeing, as an addition to training and competition, may predispose the young basketball player to increased injury risk. Future research using larger sample sizes are required to further investigate the role of participation volume and type on injury occurrence in adolescent athletes.

Understanding dog owners' increased levels of physical activity : results from RESIDE

We examined the influence of dog ownership on physical activity, independent of demographic, intrapersonal, and perceived environmental factors, in a cross-sectional survey of 1813 adults. Although only 23% of the dog owners walked their dogs 5 or more times per week, the adjusted odds of achieving sufficient physical activity and walking were 57% to 77% higher among dog owners compared with those not owning dogs (P<.05). Dog ownership was independently associated with physical activity and walking. Actively encouraging more dog walking may increase community physical activity levels.

Mismatch between perceived and objective measures of physical activity environments

Objectives : This study investigated the correspondence between measures of physical activity facilities obtained through self-report and objective audits; and identified the socio-demographic, cognitive and behavioral characteristics of those who perceive their physical activity environment to be less supportive than objective measures indicate.
Methods : Self-report surveys were completed by 1540 women recruited from 45 neighborhoods in Melbourne, Australia. Women reported perceived access to physical activity facilities within 2 km from home, and also socio-demographic, cognitive and behavioral factors. Objective data on physical activity facilities within a 2 km pedestrian catchment area around women's homes were sourced.
Results : There was relatively poor agreement between measures of access to physical activity facilities obtained via self-report and objective assessment. Mismatch between perceived and objectively-assessed environments was more common amongst younger and older women, and women of low income, with low self-efficacy for physical activity, who were less active, who reported using fewer facilities and who had lived in the neighborhood for less than 2 years.
Conclusions : Future studies of environmental determinants of physical activity should consider incorporating objective indices of access to facilities, or accounting for the systematic bias that may result from relying on self-report perceptions as an indicator of the actual physical activity environment.

A comparison of subjective and objective measures of physical activity and fitness in identifying associations with cardiometabolic risk factors

Purpose
To compare the ability of alternative measures of physical activity and fitness to quantify associations with health outcomes.

Methods
Associations between a range of subjective and objective physical activity and fitness measures and cardiometabolic risk factors were examined using data from 1,631 Australians aged 26–36 years. Anthropometry, fitness, blood pressure, and fasting blood glucose, insulin, and lipids were measured at study clinics. Participants completed the International Physical Activity Questionnaire (IPAQ) and 7-day pedometer diaries; they also reported sedentary behavior (sitting, television viewing).

Results
In men and women, associations were strongest for fitness, with those in the highest (vs. lowest) fitness quarter having a 75% to 80% lower prevalence of two or more primary risk factors (waist circumference, high-density lipoprotein cholesterol, and insulin resistance). In men, a 60% to 70% reduced prevalence of two or more risk factors was observed across extreme quarters of IPAQ leisure, IPAQ vigorous, sitting duration, and pedometer measures. Similar reductions in prevalence were observed only across extreme quarters of pedometer activity and television viewing in women.

Conclusions
Associations between alternative measures and cardiometabolic risk were relatively independent, suggesting that a range of physical activity and fitness measures may be needed to most accurately quantify associations between physical activity and health.

Occupational and non-occupational physical activity and the social determinants of physical activity : results from the Health Survey for England

Background: This article aims to examine the relative contribution of occupational activity to English adults’ meeting of government recommendations for physical activity (PA).

Methods: Data were extracted from a cross-sectional survey of householders in the UK via the Health Survey for England.¹ In total, 14,018 adult participants were included in the analysis. Multivariate logistic regression was used to examine the odds of achieving PA recommendations with and without including occupational activity and to examine the contribution of gender and social and demographic characteristics.

Results: When occupational PA was included, 36% of men and 25% of women were active at the recommended level. Once occupational PA was removed, these proportions were 23% and 19%, respectively. These results were socially patterned, most notably by age and gender.

Conclusions: Occupational PA provides a substantial contribution to those meeting the government target for PA.

The burden of physical activity-related ill health in the UK

Background: Despite evidence that physical inactivity is a risk factor for a number of diseases, only a third of men and a quarter of women are meeting government targets for physical activity. This paper provides an estimate of the economic and health burden of disease related to physical inactivity in the UK. These estimates are examined in relation to current UK government policy on physical activity.

Methods: Information from the World Health Organisation global burden of disease project was used to calculate the mortality and morbidity costs of physical inactivity in the UK. Diseases attributable to physical inactivity included ischaemic heart disease, ischaemic stroke, breast cancer, colon/rectum cancer and diabetes mellitus. Population attributable fractions for physical inactivity for each disease were applied to the UK Health Service cost data to estimate the financial cost.

Results: Physical inactivity was directly responsible for 3% of disability adjusted life years lost in the UK in 2002. The estimated direct cost to the National Health Service is £1.06 billion.

Conclusion: There is a considerable public health burden due to physical inactivity in the UK. Accurately establishing the financial cost of physical inactivity and other risk factors should be the first step in a developing national public health strategy.

Beneficial associations of physical activity with 2-h, but not fasting, blood glucose in Australian adults

OBJECTIVE--We examined the associations of physical activity with fasting plasma glucose (FPG) and with 2-h postload plasma glucose (2-h PG) in men and women with low, moderate, and high waist circumference.

RESEARCH DESIGN AND METHODS--The Australian Diabetes, Obesity and Lifestyle (AusDiab) study provided data on a population-based cross-sectional sample of 4,108 men and 5,106 women aged [greater than or equal to] 25 years without known diabetes or health conditions that could affect physical activity. FPG and 2-h PG were obtained from an oral glucose tolerance test. Self-reported physical activity level was defined according to the current public health guidelines as active ([greater than or equal to] 150 min/week across five or more sessions) or inactive (<150 min/week and/or less than five sessions). Sex-specific quintiles of physical activity time were used to ascertain dose response.

RESULTS--Being physically active and total physical activity time were independently and negatively associated with 2-h PG. When physical activity level was considered within each waist circumference category, 2-h PG was significantly lower in active high-waist circumference women ([beta] -0.30 [95% CI -0.59 to -0.01], P = 0.044) and active low-waist circumference men ([beta] -0.25 [-0.49 to -0.02], P = 0.036) compared with their inactive counterparts. Considered across physical activity and waist circumference categories, 2-h PG levels were not significantly different between active moderate-waist circumference participants and active low-waist circumference participants. Associations between physical activity and FPG were nonsignificant.

CONCLUSIONS--There are important differences between 2-h PG and FPG related to physical activity. It appears that 2-h PG is more sensitive to the beneficial effects of physical activity, and these benefits occur across the waist circumference spectrum.

The effectiveness of physical activity interventions for the treatment of overweight and obesity and type 2 diabetes

This review summarises current evidence relating to the effectiveness of physical activity (PA) interventions for treating overweight and obesity and type 2 diabetes. Interventions to increase PA for the treatment of overweight and obesity in both children and adults have primarily consisted of health education and behaviour modification strategies in clinical settings or with selected families or individuals. Although evidence is limited, strategies to reduce sedentary behaviours appear to have potential for reducing obesity among children and adolescents. Among adults, strategies that combine diet and PA are more effective than PA strategies alone. Combined lifestyle strategies are most successful for maintained weight loss, although most programs are unsuccessful in producing long-term changes. There is little evidence about compliance to prescribed behaviour changes or the factors that promote or hinder compliance to lifestyle changes. Limited evidence suggests that continued professional contact and self-help groups can help sustain weight loss. Most of the interventions for the treatment of type 2 diabetes have been conducted in clinical settings and have typically required the use of extensive resources. Evidence suggests that interventions can lead to small but clinically meaningful improvements in glycaemic control, even in the absence of weight loss. A recent study demonstrated that a multifactorial intervention (diet, PA and pharmaceutical) can reduce the risk of diabetes complications in individuals with type 2 diabetes. Nevertheless, there is little evidence about the effectiveness of community-based interventions in producing long-term changes in glycaemic control and reduced mortality in people with type 2 diabetes.