Comparison of the Physical Activity Frequency Questionnaire (PAFQ) with accelerometry in a middle-aged and elderly population: The CoLaus study

Validation Study of Physical Activity and Sedentary Behavior in African-American Men and Women

BACKGROUND

Self-reported data of physical activity are practical and inexpensive ways to collect data, although, subject to significant measurement errors. Most physical activity questionnaires used in the USA have been predominately validated among non-Hispanic White American populations with limited attention paid to the validity of the measures among racial/ethnic minorities. Additionally, there are limited studies that have evaluated factors related to over- and under-reporting errors linked to self-reported physical activity data, particularly among African Americans. The primary objectives of this study were to validate self-reported levels of physical activity and sedentary behavior among African-American men and women against objective measurements and to identify the factors related to under- and over-reporting.

METHODS

This study was a 7-day, cross-sectional study conducted on African-American men and women (n = 56) who were between 21-70 years of age. Participants were required to attend two study visits for the collection of self-reported and objective measurements of physical activity and sedentary behavior (VO2max, DEXA scan, anthropometrics, ActivPal accelerometer, resting metabolic rate (RMR) and International Physical Activity Questionnaire (IPAQ) questionnaire.

RESULTS

Overall, energy expenditure measured by ActivPal was 24.1 MET/hr/week whereas self-reported (IPAQ) energy expenditure was 52.66 MET/hr/week. Self-reported sedentary time was 40.37 h/week, whereas sedentary time measured by ActivPal was 63.03 h/week. Obese participants tended to over-report their physical activity levels more so than non-obese participants (Obese, Activpal-23.89 MET/hr/week vs IPAQ-58.98 MET/hr/week; Non-obese, Activpal - 24.48 MET/hr/week vs IPAQ - 42.55 MET/hr/week). Both obese and non-obese participants underestimated their sedentary time (Obese, Activpal - 66.89 h/week vs IPAQ-43.92 h/week; Non-obese, Activpal -56.07 h/week vs IPAQ - 33.98 h/week).

CONCLUSIONS

The results of this study found that the ActivPal validated physical activity and sedentary behavior among African-Americans. Self-reported data were found to be highly variable, whereas the objective assessments of physical activity and sedentary behavior had limited variability. It was also found that obese individuals over-estimated their self-reported physical activity levels and under-estimated sedentary behavior in comparison to the ActivPal. These findings strongly support the need to measure physical activity and sedentary behaviors objectively, particularly among African-Americans.

Adherence to 2020 ESC recommendations on physical activity in a population with different cardiovascular risk levels: A prospective population-based study from the CoLaus/PsyCoLaus study

Introduction

In 2020, the European Society of Cardiology (ESC) recommends 150 min of moderate or 75 min of vigorous-intensity PA per week. While general population PA adherence is suboptimal, its status among those with previous ASCVD or high ASCVD risk remains unknown. We aimed to assess objective adherence to ESC PA recommendations using accelerometer-based measurement among these populations.

Methodology

We used data from the Swiss CoLaus|PsyCoLaus cohort study (2014-2016). PA was measured using a 14-day wrist accelerometer. Adherence was defined as > 80 % of recommended PA achievement. Adherence was investigated separately among participants with previous ASCVD and among cardiovascular risk groups (based on the Systematic Coronary Risk Evaluation SCORE-1 and more recent SCORE2) with simple and multivariable logistic regressions. Participants' characteristics were also evaluated as independent factors after adjustment.

Results

We studied 1867 participants (median age: 61.2 years, 51.3 % female). ESC PA Adherence reached 55.5 % overall, and 37 % in those with previous ASCVD. Multivariable analysis showed no significant association between previous ASCVD or high cardiovascular risk and PA adherence (Odds ratio adjusted [ORa] 0.9, 95 % Confidence Interval [CI] 0.6-1.4 and ORa 0.7, 95 % CI 0.4-1.2, respectively). Age (≥60 years old), obesity, smoking, chronic renal disease, hypertension, diabetes and benzodiazepine use were significantly associated with lower likelihood of PA adherence in multivariable logistic regression.

Conclusion

Adherence to ESC PA guidelines, particularly in participants with higher cardiovascular risk, was poor. Since PA adherence was associated with modifiable risk factors (e.g., obesity, smoking, and benzodiazepine use), maintained efforts to implement the ESC recommendations are advised.

It needs more than a myocardial infarction to start exercising: the CoLaus|PsyCoLaus prospective study

BACKGROUND

Increased physical activity (PA) is recommended after an acute coronary event to prevent recurrences. Whether patients with acute coronary event actually increase their PA has not been assessed using objective methods such as accelerometer. We aimed to assess the subjectively and objectively measured physical activity (PA) levels of patients before and after an acute coronary event.

METHODS

Data from the three follow-up surveys of a prospective study conducted in Lausanne, Switzerland. Self-reported PA was assessed by questionnaire in the first (2009-2012) and second (2014-2017) follow-ups. Objective PA was assessed by a wrist-worn accelerometer in the second and third (2018-2021) follow-ups. Participants who developed an acute coronary event between each survey period were considered as eligible. PA levels were compared before and after the event, and changes in PA levels were also compared between participants who developed an acute event with three gender and age-matched healthy controls.

RESULTS

For self-reported PA, data from 43 patients (12 women, 64 ± 9 years) were used. No differences were found for all PA levels expressed in minutes/day before and after the event: moderate PA, median and [interquartile range] 167 [104-250] vs. 153 [109-240]; light PA: 151 [77-259] vs. 166 [126-222], and sedentary behaviour: 513 [450-635] vs. 535 [465-642] minutes/day. Comparison with gender- and age-matched healthy controls showed no differences regarding trends in reported PA. For accelerometer-assessed PA, data from 32 patients (16 women, 66 ± 9 years) were used. No differences were found for all PA levels expressed in minutes/day before and after the event: moderate PA: 159 [113-189] vs. 141 [111-189]; light PA: 95.8 [79-113] vs. 95.9 [79-117], and sedentary behaviour: 610 [545-659] vs. 602 [540-624]. Regarding the comparison with gender- and age-matched healthy controls, controls had an increase in accelerometer-assessed sedentary behaviour as % of day: multivariable adjusted average standard error 2.7 ± 0.6, while no increase was found for cases: 0.1 ± 1.1; no differences were found for the other PA levels.

CONCLUSION

Patients do not seem to change their PA levels after a first coronary event. Our results should be confirmed in larger samples.

Association between chronic pain and physical activity in a Swiss population-based cohort: a cross-sectional study

OBJECTIVE

To assess the bidirectional association between chronic pain and both subjectively and objectively measured physical activity (PA).

DESIGN

Cross-sectional study.

SETTING

Population-based sample in Lausanne, Switzerland, May 2014 to April 2017.

PARTICIPANTS

Non-stratified, representative sample of the population of Lausanne (Switzerland) aged 35-75 years. Participants were excluded if they had missing data for the pain or the PA questionnaires, for accelerometry (defined as >20% of non-wear time or duration <7 days) or for covariates.

PRIMARY OUTCOMES

Primary outcomes were association between chronic pain and previous, subjectively assessed PA (questionnaire), and subsequent, objectively assessed PA (accelerometry). Daily pain, pain duration, number of painful sites and pain intensity were assessed by questionnaire. PA was assessed by questionnaire 2 weeks prior and by accelerometry 2 weeks after completion of the pain questionnaire. PA was further categorised as sedentary (SED), light and moderate-to-vigorous PA.

RESULTS

2598 participants (52.9% women, mean age 60.5 years) had subjectively assessed PA. Multivariable analysis showed time spent in SED to be negatively associated with the number of painful sites: adjusted mean±SE 528±5, 522±7 and 502±7 min/day for 0, 1-2 and 3+ painful sites, respectively, p for trend <0.005. No other association was found between chronic pain and subjectively assessed PA categories. 2205 participants (52.8% women, mean age 61.7 years) had accelerometry-derived PA. No significant association between chronic pain and subsequent objectively assessed PA was found after multivariable analyses.

CONCLUSION

In this Swiss population-based cohort, no consistent association was found between chronic pain and PA. Hence, in the general population, chronic pain does not significantly impact time spent in PA.

Validation of an open-source ambulatory assessment system in support of replicable activity studies

Purpose: Inertial-based trackers have become a common tool in data capture for ambulatory studies that aim at characterizing physical activity. Many systems that perform remote recording of accelerometer data use commercial trackers and black-box aggregation algorithms, often resulting in data that are locked into proprietary formats and metrics that make later replication or comparison difficult.

Methods: The primary purpose of this manuscript is to validate an open-source ambulatory assessment system that consists of hardware devices, algorithms, and software components of our approach. We report on two validation experiments, one lab-based treadmill study on a convenience sample of 16 volunteers and one ’in vivo’ study with 28 volunteers suffering from diabetes or cardiovascular disease.

Results: A comparison between data from ActiGraph GT9X trackers and our proposed system reveals that the original inertial sensor signals at the wrist strongly correlate (Pearson correlation coefficients for raw inertial sensor signals of 0.97 in the controlled treadmill-walking setting) and that estimated steps from an open-source wrist-based detection approach correlate with the hip-worn ActiGraph output (average Pearson correlation coefficients of 0.81 for minute-wise comparisons of detected steps) in day-long ambulatory data.

Conclusion: Recording inertial sensor data in a standardized form and relying on open-source algorithms on these data form a promising methodology that ensures that datasets can be replicated or enriched long after the wearable trackers have been decommissioned.

Impact of night and shift work on metabolic syndrome and its components: a cross-sectional study in an active middle-to-older-aged population-based sample

OBJECTIVES

To examine the effects of work schedules on metabolic syndrome and its components in active middle-to-older-aged workers.

METHODS

A cross-sectional analysis including middle-to-older-aged active workers from the population-based CoLaus|PsyCoLaus study (Lausanne, Switzerland) was performed. Work schedule was self-reported and defined as follows: permanent day, day shift, night shift and permanent night work. Associations between work schedule and the risk of metabolic syndrome and its components were analysed using multivariable-adjusted logistic regressions.

RESULTS

A total of 2301 active workers (median age (IQR): 55.4 (50.8 to 60.4), 50.1% women) were included. Of these, 1905 were permanent day workers, 220 were day-shift workers, 134 were night-shift workers and 42 were permanent night-shift workers. There were significant interactions between sex and work schedule for metabolic syndrome, high triglycerides and visceral obesity. Men but not women permanent night workers had a higher prevalence of metabolic syndrome than permanent day workers in multivariable-adjusted analyses (OR 4.45 (95% CI 1.36 to 14.56)). Analysis of metabolic syndrome subcomponents showed that the association between work schedule and metabolic syndrome in men was mainly driven by visceral obesity (OR 3.35 (95% CI 1.04 to 10.76)). Conversely, women but not men working in night shift were at increased risk of having high triglycerides compared with permanent day workers (OR 2.92 (95% CI 1.03 to 8.27)).

CONCLUSIONS

The risk of metabolic syndrome is higher in men working in permanent night shift compared with permanent day work, and this association could be mediated by visceral obesity.

Novel CPET Reference Values in Healthy Adults: Associations with Physical Activity

PURPOSE

Cardiopulmonary exercise testing (CPET) is an important measurement in clinical practice, and its primary outcome, maximal oxygen uptake (V˙O2peak), is inversely associated with morbidity and mortality. The purposes of this study are to provide CPET reference values for maximal and submaximal parameters across the adult age spectrum of a healthy European cohort, to compare V˙O2peak values with other reference data sets, and to analyze the associations between physical activity (PA) levels and CPET parameters.

METHODS

In this cross-sectional study, we prospectively recruited 502 participants (47% female) from 20 to 90 yr old. The subjects performed a CPET on a cycle ergometer using a ramp protocol. PA was objectively and continuously measured over 14 d using a triaxial accelerometer. Quantile curves were calculated for CPET parameters. To investigate the associations between CPET parameters and PA levels, linear regression analysis was performed.

RESULTS

V˙O2peak values observed in the group of 20-29 yr were 46.6 ± 7.9 and 39.3 ± 6.5 mL·kg⋅min for males and females, respectively. On average, each age category (10-yr increments) showed a 10% lower V˙O2peak relative to the next younger age category. V˙O2peak values of previous studies were on average 7.5 mL·kg⋅min (20%) lower for males and 6.5 mL·kg⋅min (21%) lower for females. There was strong evidence supporting a positive association between the V˙O2peak (mL·kg⋅min) and the level of habitual PA performed at vigorous PA (estimate, 0.26; P < 0.001].

CONCLUSION

Maximal and submaximal CPET reference values over a large age range are novel, and differences to other studies are clinically highly relevant. Objectively measured vigorous-intensity PA showed a strong positive association with higher V˙O2peak and other performance-related CPET parameters, supporting the implementation of higher-intensity aerobic exercise in health promotion.

Validity and reliability of subjective methods to assess sedentary behaviour in adults: a systematic review and meta-analysis

BACKGROUND

Subjective measures of sedentary behaviour (SB) (i.e. questionnaires and diaries/logs) are widely implemented, and can be useful for capturing type and context of SBs. However, little is known about comparative validity and reliability. The aim of this systematic review and meta-analysis was to: 1) identify subjective methods to assess overall, domain- and behaviour-specific SB, and 2) examine the validity and reliability of these methods.

METHODS

The databases MEDLINE, EMBASE and SPORTDiscus were searched up to March 2020. Inclusion criteria were: 1) assessment of SB, 2) evaluation of subjective measurement tools, 3) being performed in healthy adults, 4) manuscript written in English, and 5) paper was peer-reviewed. Data of validity and/or reliability measurements was extracted from included studies and a meta-analysis using random effects was performed to assess the pooled correlation coefficients of the validity.

RESULTS

The systematic search resulted in 2423 hits. After excluding duplicates and screening on title and abstract, 82 studies were included with 75 self-reported measurement tools. There was wide variability in the measurement properties and quality of the studies. The criterion validity varied between poor-to-excellent (correlation coefficient [R] range - 0.01- 0.90) with logs/diaries (R = 0.63 [95%CI 0.48-0.78]) showing higher criterion validity compared to questionnaires (R = 0.35 [95%CI 0.32-0.39]). Furthermore, correlation coefficients of single- and multiple-item questionnaires were comparable (1-item R = 0.34; 2-to-9-items R = 0.35; ≥10-items R = 0.37). The reliability of SB measures was moderate-to-good, with the quality of these studies being mostly fair-to-good.

CONCLUSION

Logs and diaries are recommended to validly and reliably assess self-reported SB. However, due to time and resources constraints, 1-item questionnaires may be preferred to subjectively assess SB in large-scale observations when showing similar validity and reliability compared to longer questionnaires.

REGISTRATION NUMBER

CRD42018105994.