Work-related physical activity is not associated with body mass index and obesity

A Combined Multidisciplinary Intervention for Health Promotion in the Workplace: A Pilot Study

The aim of this study was to assess the effects of a joint health promotion intervention on a cohort of healthcare workers (HCWs) who had at least one cardiovascular risk factor. The HCWs were assessed at three different times, i.e., time zero (T0), after 6 months (T6), and after 12 months (T12). The following parameters were measured at a medical examination: physical activity, blood pressure, waist circumference, body mass index (BMI), routine laboratory tests, plicometric analysis, work ability index (WAI), and body image dissatisfaction (BID). Among the 447 HCWs, 38 HCWs were included in the study; 45% (n = 17) were male. At T12, the average blood pressure, waist/hip ratio (WHR) index, BMI, total cholesterol, triglyceride level, and blood glucose values were reduced. The levels of physical activity and adherence to the Mediterranean diet had progressively increased. The WAI showed a significant shift from low to good work performance at T12, as well as BID score. This is the first study that has analyzed work performance in relation to a workplace health promotion through a multidisciplinary approach. This health promotion intervention that combined diet and sport activity has led to a significant change in HCWs’ lifestyles and body perceptions, as well as their ability to work. This project highlights the importance of using a multidisciplinary approach and the workplace setting in health promotion programs.

Associations of physical activity at work and household income with obesity: a cross-sectional study among rural adults in Korea

OBJECTIVES

This study was performed to identify the effect of physical activity at work on obesity and to analyze the contribution of socioeconomic factors and health behaviors to this association, which has been relatively little studied.

METHODS

From the Korean National Cancer Center Community Cohort, a total of 5,587 adults (2,125 men; 3,462 women) aged more than 30 years living in rural areas were enrolled. Information on socio-demographic factors, health behaviors, and body mass index was gathered using face-to-face interviews and measurements of height and weight.

RESULTS

Inverse associations were identified between vigorous-intensity physical activity at work and obesity in both men and women, while no association was found between vigorous-intensity physical activity during leisure time and obesity. High household income was independently associated with a lower risk of obesity among those who had low levels of vigorous-intensity physical activity at work. Vigorous physical activity at work showed an inverse association with obesity in rural areas where heavy manual labor is common.

CONCLUSIONS

Our findings indicate the necessity to account for various types of physical activity to improve the assessment and prevention of obesity.

Self-reported sleep duration is associated with time in work physical activity but not transportation or leisure physical activity among Hispanic/Latino adults in the U.S.: results from the Hispanic Community Health Study/Study of Latinos

OBJECTIVES

The objective of this study is to test the hypothesis that short sleep duration is associated with fewer minutes of transportation, work, and leisure physical activity (PA).

DESIGN

This is a cross-sectional study conducted from 2008 to 2011.

SETTING

The study setting included four sites across the U.S. (Bronx, NY; Chicago, IL; Miami, FL; San Diego, CA).

PARTICIPANTS

A total of 14,653 Hispanic/Latino adults aged 18-74 years were enrolled as participants for the study.

MEASUREMENTS

Respondents reported sleep duration and transportation (including walking and cycling), work (including volunteering, paid work, and household chores), and leisure (including sports) PA domains and sociodemographic characteristics, other sleep characteristics, cardiometabolic health, health behaviors, and depressive symptoms.

RESULTS

In analyses weighted to reflect the Hispanic/Latino population of the four cities sampled, 61% had sleep duration 7-9 hours, 19% each had sleep duration < 7 hours and > 9 hours. Those sleeping < 7 hours spent 106 minutes/day in work-related PA, compared with those who spent fewer than 40 minutes/day in transportation-related or leisure-related PA. Sleep duration < 7 hours was associated with 26 minutes more in work-related PA (95% confidence interval [CI]: 16.7, 36.0), compared with sleep duration of 7-9 hours, adjusting for age and sex. Results were similar in employed respondents only, adjusting for occupation class and shift work frequency. Sleep duration was not associated with transportation-related or leisure-related PA.

CONCLUSIONS

Short sleep duration is associated with more work-related PA, both in the overall sample and among those employed. Individuals with higher work-related PA may face multiple demands and stressors that negatively influence sleep duration.

Nativity and Occupational Determinants of Physical Activity Participation Among Latinos

INTRODUCTION

Latinos in the U.S. bear a disproportionate burden of cardiovascular risk factors, including physical inactivity. Previous research among Latinos has focused on leisure-time physical activity, limiting understanding of the different ways in which populations, particularly working-class groups, achieve recommended levels of physical activity. This study examined associations of race/ethnicity; nativity; and leisure-time, transportation, and occupation-related physical activity among Latino and non-Latino white adults.

METHODS

Participants sampled in the 2007-2012 waves of the National Health and Nutrition Examination Survey self-reported domain-specific physical activity. Data were analyzed in 2016-2017 using multivariable log binomial regression models to examine differences in meeting guidelines for each physical activity domain separately and as total physical activity among Latinos (n=4,692) and non-Latino whites (n=7,788). Models were adjusted for sociodemographic characteristics and health status and tested interactions between nativity and occupational categories.

RESULTS

In adjusted models, foreign-born Latinos (prevalence ratio=0.70, 95% CI=0.63, 0.77) and U.S.-born Latinos (prevalence ratio=0.85, 95% CI=0.76, 0.95) were least likely to meet physical activity guidelines through occupation-related and leisure time physical activity, when compared with non-Latino whites. By contrast, foreign-born Latinos were more likely to meet physical activity guidelines through transportation physical activity than non-Latino whites (prevalence ratio=1.26, 95% CI=1.01, 1.56) and were proportionately more likely to participate in vigorous modes of physical activity. Interaction results indicated that foreign-born Latinos were the least likely to meet physical activity guidelines compared with U.S.-born Latinos and non-Latino whites if they worked in non-manual occupational categories. All racial/ethnic groups working in manual occupations saw the largest increase (40%-50%) in meeting physical activity guidelines when occupation-related physical activity was combined with leisure-time and transportation physical activity.

CONCLUSIONS

These findings suggest variability in the relationship between nativity and the physical activity domain Latinos engage in compared with non-Latino whites, with occupation contributing substantially to meeting physical activity recommendations for all population groups.

Combined Before-and-After Workplace Intervention to Promote Healthy Lifestyles in Healthcare Workers (STI-VI Study): Short-Term Assessment

Health care workers (HCWs) are prone to a heavy psycho-physical workload. Health promotion programs can help prevent the onset of chronic and work-related diseases. The aim of the STI-VI ‘before-and-after’ study, with assessments scheduled at 6 and 12 months, was to improve the lifestyle of HCWs with at least one cardiovascular risk factor. A tailored motivational counseling intervention, focusing on dietary habits and physical activity (PA) was administered to 167 HCWs (53 males; 114 females). BMI, waist circumference, blood pressure, and cholesterol, triglyceride, and blood glucose levels were measured before and after the intervention. The 6-month results (total sample and by gender) showed a marked effect on lifestyle: PA improved (+121.2 MET, p = 0.01), and diets became more similar to the Mediterranean model (+0.8, p < 0.001). BMI dropped (−0.2, p < 0.03), and waist circumference improved even more (−2.5 cm; p < 0.001). Other variables improved significantly: total and LDL cholesterol (−12.8 and −9.4 mg/dL, p < 0.001); systolic and diastolic blood pressure (−4.4 and −2.5 mmHg, p < 0.001); blood glucose (−1.5 mg/dL, p = 0.05); and triglycerides (significant only in women), (−8.7 mg/dL, p = 0.008); but HDL cholesterol levels dropped too. If consolidated at 12 months, these results indicate that our intervention can help HCWs maintain a healthy lifestyle and work ability.

Relationships of Musculoskeletal Symptoms, Sociodemographics, and Body Mass Index With Leisure-Time Physical Activity Among Nurses

Nurses have a high prevalence of musculoskeletal symptoms from patient handling tasks such as lifting, transferring, and repositioning. Comorbidities such as musculoskeletal symptoms may negatively affect engagement in leisure-time physical activity (LTPA). However, limited data are available on the relationship between musculoskeletal symptoms and LTPA among nurses. The purpose of this study was to describe musculoskeletal symptoms and LTPA, and to examine the relationships of musculoskeletal symptoms, sociodemographics, and body mass index with LTPA among nurses. Cross-sectional data on sociodemographics, employment characteristics, musculoskeletal symptoms, body mass index, and LTPA were collected from a statewide random sample of 454 California nurses from January to July 2013. Descriptive statistics, bivariate and multiple logistic regressions were performed. We observed that non-White nurses were less likely to engage in regular aerobic physical activity than White nurses (odds ratio [OR] = 0.61; 95% confidence interval [CI] = [0.40, 0.94]). Currently working nurses were less likely to engage in regular aerobic physical activity than their counterparts (OR = 0.48; 95% CI = [0.25, 0.91]). Nurses with higher body mass index were less likely to perform regular aerobic physical activity (OR = 0.93; 95% CI = [0.89, 0.97]) or muscle-strengthening physical activity (OR = 0.92; 95% CI = [0.88, 0.96]). This study found no evidence that musculoskeletal symptoms may interfere with regular engagement in LTPA. Physical activity promotion interventions should address employment-related barriers, and particularly target racial minority nurses and those who have a high body mass index.

Patterns of Physical Activity and the Risk of Coronary Heart Disease: A Pilot Study

Background: In the current study, we investigated the effect of physical activity (PA) on the risk of coronary heart disease (CHD). Methods: In total, 146 cases of CHD and 157 matched controls were included in the study. Data on sociodemographics, lifestyle, and medical history factors were collected using an interviewer-administered questionnaire. A standard World Health Organization (WHO)-based lifestyle questionnaire was used to assess PA. The risk of CHD was analyzed in relation to PA patterns using logistic regression. Results: Vigorous-intensity leisure PA was not associated with a lower risk of CHD. Subjects in the highest tertile of moderate occupational PA had a significantly lower risk of CHD compared to the lowest tertile (adjusted odds ratio (OR) 0.31, 95% confidence intervals (CI) 0.17–0.56). Subjects in the highest tertile of walking hasd an adjusted OR of 0.37 (95% CI 0.20–0.70). Subjects in the medium and highest tertiles of sedentary behavior had adjusted ORs of 2.01 (95% CI 1.06–3.79) and 3.88 (95% CI 2.14–7.02), respectively (p-value for trend < 0.001). Conclusion: The current results showed that both moderate occupational PA and walking protected against CHD. Sedentary behavior increased the risk of CHD.

Trends in Racial/Ethnic and Nativity Disparities in Cardiovascular Health Among Adults Without Prevalent Cardiovascular Disease in the United States, 1988 to 2014

BACKGROUND

Trends in cardiovascular disparities are poorly understood, even as diversity increases in the United States.

OBJECTIVE

To examine U.S. trends in racial/ethnic and nativity disparities in cardiovascular health.

DESIGN

Repeated cross-sectional study.

SETTING

NHANES (National Health and Nutrition Examination Survey), 1988 to 2014.

PARTICIPANTS

Adults aged 25 years or older who did not report cardiovascular disease.

MEASUREMENTS

Racial/ethnic, nativity, and period differences in Life's Simple 7 (LS7) health factors and behaviors (blood pressure, cholesterol, hemoglobin A1c, body mass index, physical activity, diet, and smoking) and optimal composite scores for cardiovascular health (LS7 score ≥10).

RESULTS

Rates of optimal cardiovascular health remain below 40% among whites, 25% among Mexican Americans, and 15% among African Americans. Disparities in optimal cardiovascular health between whites and African Americans persisted but decreased over time. In 1988 to 1994, the percentage of African Americans with optimal LS7 scores was 22.8 percentage points (95% CI, 19.3 to 26.4 percentage points) lower than that of whites in persons aged 25 to 44 years and 8.0 percentage points (CI, 6.4 to 9.7 percentage points) lower in those aged 65 years or older. By 2011 to 2014, differences decreased to 10.6 percentage points (CI, 7.4 to 13.9 percentage points) and 3.8 percentage points (CI, 2.5 to 5.0 percentage points), respectively. Disparities in optimal LS7 scores between whites and Mexican Americans were smaller but also decreased. These decreases were due to reductions in optimal cardiovascular health among whites over all age groups and periods: Between 1988 to 1994 and 2011 to 2014, the percentage of whites with optimal cardiovascular health decreased 15.3 percentage points (CI, 11.1 to 19.4 percentage points) for those aged 25 to 44 years and 4.6 percentage points (CI, 2.7 to 6.5 percentage points) for those aged 65 years or older.

LIMITATION

Only whites, African Americans, and Mexican Americans were studied.

CONCLUSION

Cardiovascular health has declined in the United States, racial/ethnic and nativity disparities persist, and decreased disparities seem to be due to worsening cardiovascular health among whites rather than gains among African Americans and Mexican Americans. Multifaceted interventions are needed to address declining population health and persistent health disparities.

PRIMARY FUNDING SOURCE

National Institute of Neurological Disorders and Stroke and National Center for Advancing Translational Sciences of the National Institutes of Health.

Urban-Rural Differences in Aerobic Physical Activity, Muscle Strengthening Exercise, and Screen-Time Sedentary Behavior

PURPOSE

Compared to their urban counterparts, US residents in rural settings face an increased risk of premature mortality and health problems that have been linked to insufficient physical activity (PA) levels. There is limited literature regarding urban-rural differences in adherence to national guidelines for all 3 PA-related behaviors.

METHODS

We investigated urban-rural differences in aerobic PA, leisure-time muscle strengthening PA, and leisure screen-time sedentary behavior in a combined data set of the 2011-2014 waves (N = 14,188) of the nationally representative National Cancer Institute's Health Information National Trends Survey.

FINDINGS

We found no evidence of a difference between large urban and rural residents' aerobic PA levels. The typical number of weekly bouts of leisure-time muscle strengthening PA was 25% lower for rural residents (incidence rate ratio [IRR] = 0.751, P < .001); this relationship was no longer statistically significant after controlling for potentially confounding covariates. In adjusted models, we found rural residents to engage in 6.6% less daily leisure screen-time sedentary behavior than their large urban counterparts (IRR = 0.934, P = .031).

CONCLUSIONS

Taken together with previous literature, these results suggest that rural residents may engage in comparable levels of total PA, but less leisure-time PA, than their urban counterparts.

Gender disparity in the associations of overweight/obesity with occupational activity, transport to/from work, leisure-time physical activity, and leisure-time spent sitting in working adults: A cross-sectional study

Background

The associations of occupational activity (OA), commuting, leisure-time physical activity (LTPA), and sitting with overweight/obesity in working adults are controversial. This study explored these factors with the risk of overall and abdominal overweight/obesity in a Chinese working population and whether these associations differ by gender.

Methods

A cross-sectional study was conducted. Data analysis was done among 6739 employed participants. Multivariate logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the studied associations.

Results

For male employees, those with heavy OA had a lower overall (OR 0.76; 95% CI, 0.62–0.93) and abdominal (OR 0.76; 95% CI, 0.62–0.93) overweight/obesity risk than those with light OA. Those with LTPA ≥150 min/week had a lower risk of overall (OR 0.73; 95% CI, 0.56–0.96) and abdominal (OR 0.70; 95% CI, 0.53–0.91) overweight/obesity than those with LTPA <150 min/week. Men with leisure-sitting time <2.5 h/day had a significantly lower risk of abdominal overweight/obesity than those sitting ≥4 h/day (OR 0.80; 95% CI, 0.65–0.99). And men who cycled to/from work had a lower risk of overall (OR 0.69; 95% CI, 0.53–0.90) and abdominal overweight/obesity (OR 0.71; 95% CI, 0.54–0.92) than passive transports. However, the above significant associations disappeared among female employees.

Conclusions

Heavy OA, cycling to/from work, and LTPA were associated with lower risk of overall or abdominal overweight/obesity in male employees. Reducing leisure sitting time can also help male employees reduce the risk of abdominal overweight/obesity. More research on gender disparity in the risk of overweight and obesity should be done.

•

Physical activity and sitting with overweight/obesity in employees were studied.

•

Heavy occupational activity had a lower overweight/obesity risk.

•

Active LTPA and cycling to work were associated with lower overweight/obesity risk.

•

Reducing leisure sitting time can reduce the risk of abdominal overweight/obesity.

•

The significant results were observed in male employees but not in females.

Different Types of Physical Activity and Fitness and Health in Adults: An 18-Year Longitudinal Study

Objective. The aim of this study is to examine the relationship between different types of daily life physical activity (PA) and physical fitness (PF) and health throughout adulthood. Methods. A total of 723 men and women, aged 28–76 years, participated 1681 times during four measurement points from 1992 to 2010 in this study. We assessed self-reported PA, anthropometrics, physical health status (HS), and PF in each study year. Hierarchical linear modeling (HLM) was used to analyze the measures. Results. PF and HS worsened with increasing age while sports activity (SA) declined. The modeling showed that sex, age, and SES play important roles concerning PA, PF, and HS. Athletes show higher HS and HF than nonathletes. Habitual activity (HA) also showed a positive relationship with PF and HS, but effects were lower than for SA. Work related activity (WRA) showed no meaningful relationship with PF or HS. Conclusions. Comparable amounts of PA can lead to different effects on PF or HS. Our findings underline the importance of contexts, content, and purposes of PA when health or fitness benefits are addressed. Simply moving your body is not enough.

Twenty-five-year trends in lifestyle and socioeconomic characteristics in Eastern Finland

Aims: Little is known about changes in lifestyle and socioeconomic characteristics among physical activity subgroups over time. This study aimed at assessing whether the lifestyle and the socioeconomic profile of people with either low total physical activity (TPA) or high TPA changed during 1972—97. Methods: Six independent cross-sectional surveys were carried out among a middle-aged population at five-year intervals in Eastern Finland, 1972—97. The participation rates varied from 71% to 95% (n=33,712). Physical activity during leisure time (LTPA) and occupational physical activity (OPA) were determined by a self-administered questionnaire. TPA was calculated by combining LTPA and OPA. Results: Men with low TPA were older, smoked more, and had a higher BMI than men with high TPA. The increase in BMI was almost fourfold in sedentary men (trend 0.4%/5 years, p=0.023 for trend) than in highly active men (trend 0.1%/5 years, p=0.044 for trend). Education no longer accounted for the socioeconomic difference after 1977. Sedentary women had a higher BMI and smoking prevalence than those with high TPA. The difference in age, education, and marital status disappeared between those two groups after 1977. Conclusions: The lifestyle and the socioeconomic profiles of people with both low TPA and high TPA have changed during 1972—97.

The impact of physical activity on cumulative cardiovascular disease risk factors among Malaysian adults

Background

Numerous studies have shown the importance of physical activity in reducing the morbidity and mortality rates caused by cardiovascular disease (CVD). However, most of these studies emphasise little on the cumulative effect of CVD risk factors. Hence, this study investigates the association between physical exercise and cumulative CVD risk factors among adults in three different age groups.

Methods

Using a sample of 7276 respondents drawn from community centers, the REDISCOVER team gathered information on physical activity, CVD risk factors (obesity, diabetes, hypertension, hypercholesterolemia, tobacco use) and socioeconomic and demographic variables in Malaysia. Because the study required medical examination, a convenience sampling frame was preferred in which all volunteers were included in the study. Fasting blood samples and anthropometric (height, weight and more) measurements were collected by trained staffs. Socio-demographic and physical activity variables were recorded through questionnaires. A Chi-square test was performed to identify the bivariate association between the covariates (socioeconomic variables, demographic variables and physical activity) and outcome variable. The association between the main exposure, physical activity, and the outcome variable, cumulative CVD risk factors, was assessed using an ordinal logistic regression model, controlling for socioeconomic status and demographic influences in three different age groups, 35–49, 50–64 and 65 and above.

Results

The mean age of participants is 51.8 (SD = 9.4). Respondents in the age groups of 35–49 (aOR_moderate = 0.12; 95 % CI: 0.02 - 0.53 ) and 65 and above (aOR_high = 0.58; 95 % CI: 0.24, 0.78) showed a statistically significant inverse relationship between physical activity and cumulative CVD risk factors. However, this relationship was not significant among respondents in the 50–64 age group suggesting the possible influence of other variables, such as stress and environment.

Conclusions

The statistically significant results show a negative association between physical exercise and cumulative CVD risk factors. However, the lack of a significant relationship in the 50–64 age group suggests the need to include other considerations in future studies, such as stress and environment.

Aerobic Capacity, Physical Activity and Metabolic Risk Factors in Firefighters Compared with Police Officers and Sedentary Clerks

Background

This study examined the association between the physical work environment and physiological performance measures, physical activity levels and metabolic parameters among German civil servants. A main focus in this study was to examine the group differences rather than measuring the absolute values in an occupational group.

Methods

We prospectively examined 198 male German civil servants (97 firefighters [FFs], 55 police officers [POs] and 46 sedentary clerks [SCs]). For each parameter, the groups were compared using a linear regression adjusted for age.

Results

The 97 FFs showed a similar maximal aerobic power (VO_2max l/min) of 3.17±0.44 l/min compared with the POs, who had a maximal aerobic power of 3.13±0.62 l/min (estimated difference, POs vs. FFs: 0.05, CI: -0.12-0.23, p=0.553). The maximal aerobic power of the FFs was slightly higher than that of the SCs, who had a maximal aerobic power of 2.85±0.52 l/min (-0.21, CI: -0.39-0.04, p=0.018 vs. FFs). The average physical activity (in metabolic equivalents [METS]/week) of the FFs was 3818.8±2843.5, whereas those of the POs and SCs were 2838.2±2871.9 (-808.2, CI: 1757.6-141.2, p=0.095) and 2212.2±2292.8 (vs. FFs: -1417.1, CI: -2302-531.88, p=0.002; vs. POs: -2974.4, CI: -1611.2-393.5, p=0.232), respectively. For the FFs, the average body fat percentage was 17.7%±6.2, whereas it was 21.4%±5.6 for the POs (vs. FFs: 2.75, CI: 0.92-4.59, p=0.004) and 20.8%±6.5 for the SCs (vs. FFs: 1.98, CI: -0.28-4.25, p=0.086; vs. POs: -0.77, CI: 3.15-1.61, p=0.523). The average waist circumference was 89.8 cm±10.0 for the FFs, 97.8 cm±12.4 (5.63, CI: 2.10-9.15, p=0.002) for the POs, and 97.3±11.7 (vs. FFs: -4.89, CI: 1.24-8.55, p=0.009; vs. POs: -0.73, CI: -5.21-3.74, p=0.747) for the SCs.

Conclusions

The FFs showed significantly higher physical activity levels compared with the SCs. The PO group had the highest cardiovascular risk of all of the groups because it included more participants with metabolic syndrome; furthermore, the POs had an average of 2.75% higher body fat, lower HDL cholesterol values and higher waist circumferences compared with the FFs and higher LDL cholesterol values compared with the SCs. Our data indicate that sedentary occupations appear to be linked to obesity and metabolic syndrome in middle-aged men.

Body mass index: accounting for full time sedentary occupation and 24-hr self-reported time use

Objectives

We used linked existing data from the 2006–2008 American Time Use Survey (ATUS), the Current Population Survey (CPS, a federal survey that provides on-going U.S. vital statistics, including employment rates) and self-reported body mass index (BMI) to answer: How does BMI vary across full time occupations dichotomized as sedentary/non-sedentary, accounting for time spent in sleep, other sedentary behaviors, and light, moderate, and vigorous intensity activities?

Methods

We classified time spent engaged at a primary job (sedentary or non-sedentary), sleep, and other non-work, non-sleep intensity-defined behaviors, specifically, sedentary behavior, light, moderate, and vigorous intensity activities. Age groups were defined by 20–29, 30–39, 40–49, and 50–64 years. BMI groups were defined by 18.5–24.9, 25.0–27.4, 27.5–29.9, 30.0–34.9, and ≥35.0 kg/m². Logistic and linear regression were used to examine the association between BMI and employment in a sedentary occupation, considering time spent in sleep, other non-work time spent in sedentary behaviors, and light, moderate, and vigorous intensity activities, sex, age race/ethnicity, and household income.

Results

The analysis data set comprised 4,092 non-pregnant, non-underweight individuals 20–64 years of age who also reported working more than 7 hours at their primary jobs on their designated time use reporting day. Logistic and linear regression analyses failed to reveal any associations between BMI and the sedentary/non-sedentary occupation dichotomy considering time spent in sleep, other non-work time spent in sedentary behaviors, and light, moderate, and vigorous intensity activities, sex, age, race/ethnicity, and household income.

Conclusions

We found no evidence of a relationship between self-reported full time sedentary occupation classification and BMI after accounting for sex, age, race/ethnicity, and household income and 24-hours of time use including non-work related physical activity and sedentary behaviors. The various sources of error associated with self-report methods and assignment of generalized activity and occupational intensity categories could compound to obscure any real relationships.

Associations between active commuting, body fat, and body mass index: population based, cross sectional study in the United Kingdom

OBJECTIVE

To determine if promotion of active modes of travel is an effective strategy for obesity prevention by assessing whether active commuting (walking or cycling for all or part of the journey to work) is independently associated with objectively assessed biological markers of obesity.

DESIGN

Cross sectional study of data from the wave 2 Health Assessment subsample of Understanding Society, the UK Household Longitudinal Study (UKHLS). The exposure of interest, commuting mode, was self reported and categorised as three categories: private transport, public transport, and active transport.

PARTICIPANTS

The analytic samples (7534 for body mass index (BMI) analysis, 7424 for percentage body fat analysis) were drawn from the representative subsample of wave 2 respondents of UKHLS who provided health assessment data (n = 15,777).

MAIN OUTCOME MEASURES

Body mass index (weight (kg)/height (m)(2)); percentage body fat (measured by electrical impedance).

RESULTS

Results from multivariate linear regression analyses suggest that, compared with using private transport, commuting by public or active transport modes was significantly and independently predictive of lower BMI for both men and women. In fully adjusted models, men who commuted via public or active modes had BMI scores 1.10 (95% CI 0.53 to 1.67) and 0.97 (0.40 to 1.55) points lower, respectively, than those who used private transport. Women who commuted via public or active modes had BMI scores 0.72 (0.06 to 1.37) and 0.87 (0.36 to 0.87) points lower, respectively, than those using private transport. Results for percentage body fat were similar in terms of magnitude, significance, and direction of effects.

CONCLUSIONS

Men and women who commuted to work by active and public modes of transport had significantly lower BMI and percentage body fat than their counterparts who used private transport. These associations were not attenuated by adjustment for a range of hypothesised confounding factors.

Patterns and socio-demographic correlates of domain-specific physical activities and their associations with adiposity in the China Kadoorie Biobank study

Background

Domain-specific physical activities may have different correlates and health effects, but few large studies have examined these questions, especially their separate associations with adiposity.

Methods

We analysed cross-sectional data of 466 605 adults without any prior chronic diseases, enrolled during 2004–8, from 10 diverse localities across China. Physical activity level in each of 4 domains (occupation, commuting, household, and active-recreation), calculated as metabolic equivalent (MET)-hr/day, was related to social-demographic factors and measures of adiposity (body mass index [BMI], waist circumference [WC], and bio-impedance derived percentage body fat), using multivariable linear and logistic regression models.

Results

The overall mean age was 50.8 years. The mean total physical activity was 21.7 MET-hr/day, mainly from occupation (62%) and household chores (26%), but little from active-recreation (4%), with women having a much higher household activity than men. Older participants had a lower level of occupational activity but a higher level of household and active-recreational activity, particularly after retirement. There was no linear association of occupational activity with adiposity, but working women tended to have a lower adiposity (e.g. 1.0 cm WC) than non-working women. In men, there was an inverse and apparently linear association between adiposity and levels of both commuting-related and household activities, with 3 MET-hr/day associated with -0.11 and -0.13 kg/m² BMI, -0.42 and -0.62 cm WC, and -0.28 and -0.33 percentage points of body fat, respectively. In women, only household activity showed a linear, but weaker, association with adiposity. A higher adiposity was observed among men and women with higher levels of active-recreational activity.

Conclusions

In Chinese adults, physical activity mainly involves occupation and housework, with little from active-recreational activity. Domain-specific physical activities varied by socio-demographic factors and had different associations with adiposity.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2458-14-826) contains supplementary material, which is available to authorized users.

Is the different time trend (1997-2008) of the obesity prevalence among adults in the three Belgian regions associated with lifestyle changes?

Background

Obesity is a major public health issue with increasing prevalence among adults. However, in Belgium the regional time trends (1997–2008) differed: the prevalence of obesity increased in the Flemish and Brussels Regions, but remained stable in the Walloon Region, the latter still showing the highest prevalence. The purpose of the present study is to explore if the different time trends of obesity prevalence in the three Belgian regions is associated with lifestyle changes.

Methods

We used data from four successive cross-sectional waves (1997, 2001, 2004 and 2008) of the Belgian Health Interview Survey. The study was restricted to the adult population, resulting in samples of respectively 8,071, 9,391, 10,319 and 8,831 individuals. In line with the WHO definition, obesity was defined as having a BMI ≥ 30. Differences in regional trends of obesity were investigated through stratified analyses. The association between obesity and survey year, adjusted for lifestyle factors (alcohol consumption, smoking, fruit and vegetables consumption and leisure time physical activity), was assessed via logistic regression models. Interactions were added to the models to explore if the association between lifestyle factors and obesity varied over time.

Results

Obesity was associated with daily alcohol use in the Brussels (OR 0.66, 95% CI 0.50-0.88) and Walloon Regions (OR 0.8, 95% CI 0.6-0.9), with lower tendencies of being obese for daily drinkers. The probability of being obese was lower among smokers in the Flemish (OR 0.7, 95% CI 0.6-0.8) and Walloon Regions (OR 0.7, 95% CI 0.6-0.9) than among non-smokers. A lack of leisure time physical activity was associated with the probability of being obese in all regions (Brussels Region: OR 1.6, 95% CI 1.3-1.8; Flemish Region: OR 1.6, 95% CI 1.4-1.9; Walloon Region: OR 1.8, 95% CT 1.6-2.1). This association decreased significantly between 1997 and 2008 only in the Walloon Region.

Conclusion

The decreasing association between obesity and a lack of leisure time physical activity in the Walloon Region between 1997 and 2008 could indicate that there is an increasing awareness of risk factors for obesity in the Walloon population, which may have resulted in a more favourable evolution of the obesity epidemic.

Gender differences and socioeconomic status in relation to overweight among older Korean people

Background

The ever-increasing older population and its association with serious overweight problems have garnered much attention. The correlation between being overweight and socioeconomic status factors could be helpful for understanding the inequalities among the overweight population. We examined the correlation between being overweight and some key variables, such as demographics, socioeconomic status, general health status, and health behavior in a large sample of older individuals, by each gender.

Methods

We used data from the 2008 Korean Longitudinal Study of Aging and it included 8,157 participants who were 45 years or older. To understand the relationship between the overweight participants in accordance to demographic and socioeconomic characteristics, health status, and health behaviors, a weighted chi-square test and logistic regression analysis were conducted by separating variables related to overweight, according to the genders.

Results

The number of people in the normal group was 6,347 (77.8%), while the people who were considered overweight were 1,810 (22.2%). Women (n = 4,583) constituted 52.7% of the subject, 24.9% of whom were classified as overweight. Meanwhile, 20.6% of the 47.3% (n = 3,574) of the sample who were men were classified as overweight. Participants between the ages of 45 and 64 with chronic diseases were more likely to be overweight. Men in the 4th quartile of household income were more likely to be overweight than those who were in the 1st quartile, in contrast, while unemployed women with lower education levels and urban residents were at greater risk for being overweight.

Conclusions

Among the men, health status and health behavior appeared to show a correlation with being overweight; however, among women, socioeconomic status factors were strongly related to being overweight. These findings appear to support the association of gender-specifics with the prevalence of being overweight.

Prevalence of Risk Factors for Non-Communicable Diseases in the Adult Population of Urban Areas in Kabul City, Afghanistan

BACKGROUND

Non-Communicable diseases (NCDs) are a major global problem. This study aims to estimate the prevalence of common risk factors for NCDs among the adult population in urban areas of Kabul city, Afghanistan.

METHODS AND MATERIALS

This study was conducted from December 2011 through March 2012 and involved a survey of 1169 respondents, aged 40 years and above. Multistage cluster sampling was used for participant selection, followed by random sampling of the participants. The World Health Organization STEPwise approachfor Surveillance (STEPS) was modified and used for this study.

RESULTS

The overall prevalence of smoking was 5.1% (14.7% men versus 0.3% women) and using mouth snuff was 24.4% in men and 1.3% in women. The prevalence of obesity and hypertension were 19.1% and 45.2 % in men and 37.3% and 46.5% in women. Prevalence of diabetes was 16.1% in men and 12% in women. The overall prevalence of obesity, hypertension and diabetes mellitus was 31.2%, 46% and 13.3%, respectively. On average, subjects consumed 3.37 servings of fruit and 2.96 servings of leafy vegetables per week. Mean walking and sitting hours per week (as proxies for physical activity) were 19.4 and 20.5, respectively. A multivariate model demonstrated that age was a significant risk factor for obesity (OR=1.86), diabetes (OR=2/09) and hypertension (OR=4.1). Obesity was significantly associated with sex (OR=1.65).

CONCLUSION

These results highlight the need for interventions to reduce and prevent risk factors of non-communicable diseases in urban areas of Kabul City, Afghanistan.

How is post-industrial decline associated with the geography of physical activity? Evidence from the Health Survey for England

In recent decades, the prevalence of physical activity has declined considerably in many developed countries, which has been related to rising levels of obesity and several weight-related medical conditions, such as coronary heart disease. There is evidence that areas exhibiting particularly low levels of physical activity have undergone a strong transition away from employment in physically demanding occupations. It is proposed that such processes of deindustrialisation may be causally linked to unexplained geographical disparities in physical activity. This study investigates how geographical variations in deindustrialisation are associated with current levels of physical activity across different activity domains and relevant macro-economic time periods in England. The analysis includes data on 27,414 adults from the Health Survey for England 2006 and 2008 who reported total, occupational, domestic, recreational and walking activity. Based on employment change in industries associated with heavy manual work, a local measurement of industrial decline was developed, covering the period 1841–2001. We applied a multilevel modelling approach to study associations between industrial decline and physical activity. Results indicate that the process of deindustrialisation appears to be associated with patterns of physical activity and that this is independent of household income. The effects observed were generally similar for men and women. However, the nature of the association differed across areas, time periods and employment types; in particular, residents of districts characterised by a history of manufacturing and mining employment had increased odds of reporting low activity levels. We conclude that post-industrial change may be a factor in explaining present-day variations in physical activity, emphasising the plausible impact of inherited cultures and regional identities on health related behaviours.

•

This study is the first to link different physical activity domains to the historical context of deindustrialisation

•

We found some evidence that processes of deindustrialisation may be associated with lower physical activity

•

Lower overall activity was generally seen in areas with historically high employment then decline in manufacturing and mining

•

Findings suggest cultures of non-participation in physical activity may persist in areas experiencing losses in manual jobs

Physical Activity Levels, Sport Activities, and Risk of Acute Myocardial Infarction

Physical activity (PA) during leisure time has been inversely associated with cardiovascular disease risk in the Western populations. We evaluated PA at work and leisure time in relation to acute myocardial infarction (AMI) in Chinese population. We conducted a hospital-based case–control study. The cases had first AMI (n = 2909). The controls (n = 2947) were matched to the cases in age and sex. The odds ratios (ORs) of leisure-time PA for strenuous exercise compared to mainly sedentary was 0.74 (95% confidence interval [CI]: 0.61-0.90) and for moderate exercise it was 0.96 (95% CI: 0.85-1.08). Multivariate adjustment did not substantially alter the association. The ORs of work-related PA for heavy PA compared to mainly sedentary was 1.44 (95% CI: 1.06-1.94), for climbing and lifting was 1.00 (95% CI: 0.77-.30), and for walking was 0.90 (95%CI: 0.75-1.07). Leisure-time PA was protective for AMI risk compared to sedentary lifestyles in a population in China.

Sedentary Behaviors, Physical Activity, and Metabolic Syndrome in Middle-aged French Subjects

OBJECTIVE

To study the relationships of time spent in sedentary occupations with the National Cholesterol Education Program-defined metabolic syndrome (MS), taking into account the habitual level of physical activity (PA).

RESEARCH METHODS AND PROCEDURES

This was a cross-sectional analysis in 1902 men and 1932 women 50 to 69 years of age participating in the French Supplementation with Antioxidant Vitamins and Minerals study. We assessed past-year PA, television watching or computer use, and reading during leisure with the Modifiable Activity Questionnaire. Subjects who performed at least 150 min/wk of moderate-intensity PA (3 to 6 metabolic equivalent tasks) or 60 min/wk of vigorous PA (>6 metabolic equivalent tasks) were considered as meeting recommended levels.

RESULTS

The frequency of most MS components increased with time spent in front of a screen and decreased with increasing PA levels. The likelihood to have MS, adjusted for age, education, and smoking, was decreased by one-third in subjects meeting moderate PA guidelines and by two-thirds in subjects meeting vigorous PA recommendations [odds ratio (95% CI), 0.34 (0.17 to 0.66) in women, 0.44 (0.28 to 0.68) in men] compared with those with insufficient PA. Independently of PA levels, time spent in front of a screen was positively associated with the likelihood to have the MS in women [odds ratio (95% CI), 3.30 (2.04 to 5.34)], whereas in both sexes, no association was found with time spent reading.

DISCUSSION

The relationship of the MS with a sedentary lifestyle differs according to sex and type of sedentary occupation. These results suggest the need to assess selected indicators of sedentary behavior in preventive programs.

Cross-sectional Relationship of Pedometer-Determined Ambulatory Activity to Indicators of Health

OBJECTIVE

To describe the cross-sectional relationship between an objective measure of walking (pedometer-determined steps/day) and general indicators of health, a prior diagnosis of one or more components of the metabolic syndrome, and self-reported occupational activity in a generally sedentary working population.

RESEARCH METHODS AND PROCEDURES

Steps/day were compared with previous diagnosis of one or more components of the metabolic syndrome (by self-administered questionnaire) and with general health indicators including BMI, waist circumference, resting heart rate, and blood pressure in 182 subjects in Prince Edward Island, Canada. Study participants were volunteer employees recruited from five workplaces where, in general, the job types were moderately or highly sedentary.

RESULTS

Steps/day were 7230 +/- SD 3447 for women (n = 153) and 8265 +/- 2849 (n = 21) for men. Pedometer-determined steps/day were associated inversely with BMI (r = -0.4005, p < 0.0001) in all participants and waist circumference in females only (r = -0.4303, p < 0.0001). There was a low correlation between steps/day and diastolic blood pressure in the whole sample (r = -0.2140, p = 0.0383). Participants who reported a prior diagnosis of one or more components of the metabolic syndrome (hypertension, hypercholesterolemia, heart disease, or type 2 diabetes) took fewer steps/day than healthy participants (p = 0.0254). Pedometer-determined steps/day were positively associated with self-reported occupational activity (p = 0.0002).

DISCUSSION

Fewer steps/day are associated with increased BMI, waist circumference, diastolic blood pressure, and components of the metabolic syndrome. Low occupational activity is a contributing factor to low total ambulatory activity.

Profile of Overweight and Obese People in a Mediterranean Region

OBJECTIVE

To assess the prevalence of excess weight (obesity and overweight) and the related environmental risk factors in a Mediterranean population. Self-perception of body weight, attitudes toward weight-control behaviors, and the associated factors were also examined.

RESEARCH METHODS AND PROCEDURES

A cross-sectional nutritional survey was carried out in the Balearic Islands between 1999 and 2000. A random sample (n = 1200) of the adult population (20 to 60 years old) was interviewed. Dietary questionnaires and a global questionnaire incorporating questions related to sociodemographic and lifestyle variables were utilized. Anthropometric measurements were also obtained.

RESULTS

Nearly one-half of the population of the Balearic Islands is above the normal weight range (BMI > 25). The predictors of overweight and obesity in the Balearic Islands are to be over 40 years old, to be married, to form part of the lowest educational levels, and to have a sedentary lifestyle. A large percentage of excess-weight individuals tend to underestimate their BMI, are not concerned about their weight status, tend to snack more often, and have never dieted.

DISCUSSION

Although the likely causes of the rise in obesity prevalence are difficult to elucidate from this study, we have identified the profile of individuals with excess weight in the Balearic Islands as well as their attitudes toward their body image.

Leisure time and occupational physical activity in relation to obesity and insulin resistance: a population-based study from the Skaraborg Project in Sweden

The objective was to study obesity and insulin resistance in relation to leisure time physical activity (LTPA) and occupational physical activity (OPA) in a Swedish population, with particular focus on sex differences. Using a cross-sectional design, waist circumference, body mass index (BMI), glucose/insulin metabolism, blood pressure, heart rate, self-reported education, smoking, alcohol consumption, LTPA, and OPA were assessed in 1745 men and women (30-74 years) randomly chosen from 2 municipalities in southwestern Sweden. In both men and women, LTPA was inversely associated with BMI, waist circumference, and the homeostasis model assessment of insulin resistance (HOMA-IR), respectively. These associations remained statistically significant after adjustments for age, OPA, education, alcohol consumption, smoking, and study area, and also for BMI in the analyses concerning waist circumference and HOMA-IR. A statistically significant interaction term (P = .030), adjusted for multiple confounders, revealed a stronger association between LTPA and HOMA-IR in women compared with men. Occupational physical activity was positively associated with BMI (P < .001), waist circumference (P < .001), and HOMA-IR (P = .001), however, only in women. These associations remained when adjusting for multiple confounders. The sex differences were confirmed by statistically significant interaction terms between sex and OPA in association with BMI, waist circumference, and HOMA-IR, respectively. The observed sex differences regarding the strength of the association between LTPA and insulin resistance, and the positive association between OPA and obesity and insulin resistance found solely in women, warrant further investigation. Although exploration of the metabolic effects of OPA appears to be needed, thorough measurement of potential confounders is also vital to understand contextual effects.

Cross-sectional associations between occupational and leisure-time sitting, physical activity and obesity in working adults

AIM

To examine associations between occupational and leisure-time sitting, physical activity and obesity in working adults.

METHODS

We analyzed data from workers from the 2007-08 Australian National Health Survey (n=10,785). Participants reported their activity at work (mostly sitting, standing, walking, or heavy labor), transport-related walking, leisure-time sitting and physical activity. Body mass index was objectively measured. Adjusted Cox proportional hazard regression models examined associations between occupational activity category, leisure-time sitting, physical activity and obesity risk.

RESULTS

Substantial proportions of men (42%) and women (47%) mostly sit at work. Workers with sitting jobs were significantly more likely to be sufficiently active during leisure-time than workers with mostly standing, walking or heavy labor jobs (RR=0.88, 0.80, 0.86 respectively). Workers with mostly sitting jobs had significantly higher overweight/obesity risk than workers with mostly standing jobs (RR=0.88, 95% CI: 0.82-0.95) independent of physical activity and leisure-time sitting. Workers with leisure-time sitting of less than four hours per day had significantly lower obesity risk than workers with four or more hours per day of leisure-time sitting (RR=0.77, 95%CI: 0.69-0.87) independent of physical activity and occupational activity.

CONCLUSIONS

Sitting time and physical activity are independently associated with obesity. Leisure-time sitting may have a stronger association with obesity risk than occupational sitting.

Physical activity levels, ownership of goods promoting sedentary behaviour and risk of myocardial infarction: results of the INTERHEART study

AIMS

To evaluate the association between occupational and leisure-time physical activity (PA), ownership of goods promoting sedentary behaviour, and the risk of myocardial infarction (MI) in different socio-economic populations of the world. Studies in developed countries have found low PA as a risk factor for cardiovascular disease; however, the protective effect of occupational PA is less certain. Moreover, ownership of goods promoting sedentary behaviour may be associated with an increased risk.

METHODS

In INTERHEART, a case-control study of 10 043 cases of first MI and 14 217 controls who did not report previous angina or physical disability completed a questionnaire on work and leisure-time PA.

RESULTS

Subjects whose occupation involved either light [multivariable-adjusted odds ratio (OR) 0.78, confidence interval (CI) 0.71-0.86] or moderate (OR 0.89, CI 0.80-0.99) PA were at a lower risk of MI, whereas those who did heavy physical labour were not (OR 1.02, CI 0.88-1.19), compared with sedentary subjects. Mild exercise (OR 0.87, CI 0.81-0.93) as well as moderate or strenuous exercise (OR 0.76, CI 0.69-0.82) was protective. The effect of PA was observed across countries with low, middle, and high income. Subjects who owned both a car and a television (TV) (multivariable-adjusted OR 1.27, CI 1.05-1.54) were at higher risk of MI compared with those who owned neither.

CONCLUSION

Leisure-time PA and mild-to-moderate occupational PA, but not heavy physical labour, were associated with a reduced risk, while ownership of a car and TV was associated with an increased risk of MI across all economic regions.

Occupational physical activity and body mass index (BMI) among Canadian adults: does physical activity at work help to explain the socio-economic patterning of body weight?

BACKGROUND

The behavioural and socio-cultural processes underlying the association between socio-economic position (SEP) and body mass index (BMI) remain unclear. Occupational physical activity (OPA) is one plausible explanatory variable that has not been previously considered.

OBJECTIVES

1) To examine the association between OPA and BMI, and 2) to examine whether OPA mediates the SEP-BMI association, in a Canadian population-based sample.

METHODS

This cross-sectional study was based on secondary analysis of the 2008 Canadian Community Health Survey data, focusing on adults (age 25-64) working at a job or business (men, n = 1,036; women, n = 936). BMI was based on measured height and weight and we derived a novel indicator of OPA from the National Occupational Classification Career Handbook. Our analytic technique was ordinary least squares regression, adjusting for a range of socio-demographic, health and behavioural covariates.

RESULTS

OPA was marginally associated with BMI in women, such that women with medium levels of OPA tended to be lighter than women with low levels of OPA, in adjusted models. No associations between OPA and BMI were detected for males. Baron and Kenny's (1986) three conditions for testing mediation were not satisfied, and thus we were unable to proceed with testing OPA as a mediator.

CONCLUSIONS

Notwithstanding the small effects observed in women, overall the associations between OPA and BMI were neither clear nor strong, which could reflect conceptual and/or methodological reasons. Future research on this topic might incorporate other plausible explanatory variables (e.g., job-related psychosocial stress) and adopt a prospective design.

Relationships of occupational and non-occupational physical activity to abdominal obesity

HYPOTHESIS

Physically active occupations may protect against the risk of abdominal obesity.

OBJECTIVES

This study assessed the interaction between non-occupational physical activity (NOA) (leisure-time, transport and domestic activity) and occupational activity (OA) in relation to abdominal obesity.

METHODS

A total of 3539 adults over the age of 20, with no work limitations, employed in one of the 17 occupations classified as low OA (LOA) or high OA (HOA) were identified in the 1999-2004 National Health and Nutrition Examination Survey. Waist circumference (WC) was used to categorize individuals into either non-obese or abdominally obese (WC>88 cm in women and >102 cm in men) categories. NOA was divided into three categories based upon physical activity guidelines: (1) no NOA; (2) insufficient NOA; and (3) sufficient NOA. Logistic regression was used to examine possible associations between NOA, OA and abdominal obesity.

RESULTS

In those who are sedentary outside of work, a high-activity occupation reduces the odds risk ratio of being categorized with abdominal obesity to 0.37 in comparison with those who work in low-activity occupations. For people working in low-activity occupations, there was a clear association with activity outside of work and the odds risk ratio of being categorized with abdominal obesity. In these adults, a reduced odds ratio was found only among those who met the physical activity guidelines through NOA (odds ratio=0.55; 95% confidence interval (CI)=0.40-0.75).

CONCLUSION

HOA is associated with a reduced risk of abdominal obesity. Thus, it is important to include OA in studies seeking to understand the association between physical activity and abdominal adiposity.

Racial/ethnic disparities in exercise and dietary behaviors of middle-aged and older adults

BACKGROUND

Differences in health behaviors may be important contributors to racial/ethnic disparities in the health status of adults. Studies to date have not compared whether there are health behavior differences in exercise and dietary behaviors among middle-age and older adults in the four largest racial/ethnic categories.

OBJECTIVE

To investigate racial/ethnic differences in exercise and dietary behaviors of middle-aged and older adults.

DESIGN

We used data from the 2007 California Health Interview Survey. Multivariable logistic regression was used to examine interactions between age and race/ethnicity in predicting two categories of health behaviors. Analyses were conducted adjusting for sociodemographic characteristics, health insurance status, and healthcare utilization.

PARTICIPANTS

A population-based sample of 33,189 California adults 45 years old and older: 26,522 non-Hispanic whites, 1,686 African American/blacks, 2,565 Asian/Pacific Islanders (1,741 English-proficient; 824 limited English-proficient), and 2,416 Latinos (1,538 English-proficient; 878 limited English-proficient).

MAIN MEASURES

Self-report leisure-time physical activity (moderate and vigorous) and daily consumption of fruits and vegetables.

KEY RESULTS

Racial/ethnic minorities generally engaged in less healthy exercise and dietary behaviors than whites, with differences more pronounced in middle adulthood. The disparities were the greatest among English-proficient minorities. Specifically, among middle-aged respondents, all racial/ethnic minorities engaged in less vigorous physical activity than whites (ORs range = 0.28 to 0.73; 95% CI range = 0.16-1.00). Additionally, middle-aged, English-proficient minorities engaged in less moderate physical activity compared to whites (ORs range =0.57 to 0.67; 95% CI range = 0.45-0.79). Furthermore, middle-aged, English-proficient Latinos had a poorer diet than whites (OR = 0.54; 0.39-0.75). Few significant racial/ethnic differences emerged in the exercise and dietary behaviors of older adults.

CONCLUSIONS

Racial/ethnic disparities in exercise and dietary behaviors are most notable among middle-aged, acculturated minorities. Results highlight the need to promote positive exercise and dietary behaviors during critical preventive ages, when racial/ethnic disparities are large and the potential to prevent chronic disease is great.

Sedentary work, low physical job demand, and obesity in US workers

BACKGROUND

Little is known about the role of low physical activity at work (sedentary work or low physical job demand) in the increasing prevalence of obesity of US workers.

METHODS

This cross-sectional and secondary data analysis included 1,001 male and 1,018 female workers (age range: 32-69) from the National Survey of Midlife Development in the United States (MIDUS) II study (2004-2006). Sedentary work and physical job demand were measured by questionnaire items. Total obesity (based on body mass index) and central obesity (based on waist circumference) were defined using WHO criteria.

RESULTS

After controlling for covariates (socio-demographic, psychosocial working conditions, health status, and health behaviors), sedentary work, low physical job demand, or their combination increased the risk for total and central obesity in male workers, particularly when they worked longer than 40 hr per week. Sedentary work marginally increased the risk for total and central obesity in female workers.

CONCLUSIONS

Low physical activity at work is a significant risk factor for total and central obesity in middle-aged US male workers.

Joint associations of physical activity and sedentary behaviors with body mass index: results from a time use survey of US adults

OBJECTIVE

Obesity risk is negatively associated with physical activity and positively associated with time spent in sedentary behaviors. Yet, it is not known how different combinations of sedentary and active behavior are associated with body mass index (BMI). This study examined the interaction between time spent in physical activity and sedentary behavior on BMI in US adults.

DESIGN

Cross-sectional, data from the 2006 American Time Use Survey.

SUBJECTS

10 984 non-underweight adults (aged 21 + years).

MEASUREMENT

A phone interview assessed all activities performed in the past 24 h, height, weight, health status, and other sociodemographic characteristics. Time spent in (1) moderate-to-vigorous leisure-time physical activity (MVPA), (2) active transportation (walking, biking), (3) sedentary leisure activities (TV/movie watching, computer use, playing games, reading), and (4) sedentary transportation (motorized vehicles) was determined from activity coding. BMI was calculated.

RESULTS

After adjusting for age, gender, education level, race/ethnicity, and health status, sample-weighted linear regressions found significant interactions for leisure MVPA x TV/movies, leisure MVPA x playing games, active transportation x sedentary transportation, and active transportation x reading (Ps<0.0001). For example, the group of adults watching <60 min per day of TV/movies and engaging in > or =60 min per day of leisure MVPA had lower average BMI compared to the group watching <60 min per day of TV/movies and reporting <60 min per day of leisure MVPA (P<0.0001). In contrast, for adults watching > or =189 min per day of TV/movies, there was not a significant difference in BMI by time spent in leisure MVPA.

CONCLUSION

Data from a US time use survey indicate that the strength of the association between certain types of sedentary behavior and BMI varies according to time spent in certain types of physical activity and vice versa.

Occupational sitting and health risks: a systematic review

CONTEXT

Emerging evidence suggests that sedentary behavior (i.e., time spent sitting) may be negatively associated with health. The aim of this study was to systematically review the evidence on associations between occupational sitting and health risks.

EVIDENCE ACQUISITION

Studies were identified in March-April 2009 by literature searches in PubMed, PsycINFO, CENTRAL, CINAHL, EMBASE, and PEDro, with subsequent related-article searches in PubMed and citation searches in Web of Science. Identified studies were categorized by health outcome. Two independent reviewers assessed methodologic quality using a 15-item quality rating list (score range 0-15 points, higher score indicating better quality). Data on study design, study population, measures of occupational sitting, health risks, analyses, and results were extracted.

EVIDENCE SYNTHESIS

43 papers met the inclusion criteria (21% cross-sectional, 14% case-control, 65% prospective); they examined the associations between occupational sitting and BMI (n=12); cancer (n=17); cardiovascular disease (CVD, n=8); diabetes mellitus (DM, n=4); and mortality (n=6). The median study-quality score was 12 points. Half the cross-sectional studies showed a positive association between occupational sitting and BMI, but prospective studies failed to confirm a causal relationship. There was some case-control evidence for a positive association between occupational sitting and cancer; however, this was generally not supported by prospective studies. The majority of prospective studies found that occupational sitting was associated with a higher risk of DM and mortality.

CONCLUSIONS

Limited evidence was found to support a positive relationship between occupational sitting and health risks. The heterogeneity of study designs, measures, and findings makes it difficult to draw definitive conclusions at this time.

Individual, family, and area predictors of BMI and BMI change in an adult Norwegian population: findings from the HUNT study

The global obesity epidemic is a major public health concern and there is strong evidence that the drivers are varied and operate via diverse pathways. Taking a systems approach allows the contextual influences operating upon the individual to be identified and quantified. We adopt such a perspective in this study, where longitudinal data from a cohort of 24,966 settled individuals participating in two major health surveys, the Nord-Trøndelag Health Study (HUNT 1 and 2) in the county of Nord-Trøndelag, Norway, were used to investigate associations between individual, family and area characteristics and two outcomes: body mass index (BMI) at follow-up and BMI change over an 11 year period. Linear multilevel models were fitted, with individuals nested in 17,500 families, 447 wards and 24 municipalities. A range of putative individual, family, and area predictors were tested. We found both outcomes were strongly associated with individual characteristics, with higher BMIs generally being amongst males, unmarried participants, non-smokers, those of lower education and those undertaking physically demanding work but participating in less physical activity outside work. The characteristics of those in the sample exhibiting higher BMI gain were rather similar except that women gained more and those with no employment income gained less. Contextual influences were also found to be important: although just 1% of the unexplained variance was located on the neighbourhood and municipality levels respectively, and hence suggesting small environmental influences, between 10 and 13% could be attributed to families, highlighting the importance of the familial contextual environment. Rather little is known about the manner by which family influences may operate on bodyweight hence further work is needed to understand likely mechanisms and guide future interventions.

BMI distribution/social stratification in Swiss conscripts from 1875 to present

BACKGROUND/OBJECTIVES

We aimed to extend the actual overweight discussion with new unbiased Swiss conscript data from 2005 to 2006, and to present for the first time Swiss data on body mass index (BMI) before 1950 and for the late-nineteenth century.

SUBJECTS/METHODS

For this study, 19-year-old Swiss male conscripts (draft army; Cantons Bern, Zurich, Basel-Stadt and Basel-Land) from the census of 1875-1879, 1933-1939 and 2005-2006 (N=28 033; 2005-2006 census) were included. BMI distribution (World Health Organization (WHO) classification) and social stratification (International Labour Organization classification) were main outcome measures.

RESULTS

Mean BMI of 19-year-old men in Switzerland increased in the 50 years between the 1870s and the 1930s by 0.80 kg/m(2) and between the 1930s and 2005 by 1.45 kg/m(2). The modern BMI sample is much more right skewed and s.d. is higher. Obesity prevalence (according to modern WHO classification) has increased by a factor of 105 from 1870s until present. Over 23% of our representative sample of Swiss men in 2005-2006 had a BMI of over 25 kg/m(2). In 2005-2006, contrary to the nineteenth century, unskilled workers had articulately higher BMI values at the 75th, 90th and 95th percentile than students; 12% of unskilled workers were obese against 2% of students.

CONCLUSIONS

It thus seems that BMI relations between the upper and the lower end of the socio-economic strata changed inversely from the late-nineteenth century to 2005-2006. We further propose that the phenomenon of massive right-skewing BMI distribution between the 1930s and 2005-2006 affected the lower socio-economic strata to a far greater extent than the higher socio-economic group.

Physical activity of Croatian population: cross-sectional study using International Physical Activity Questionnaire

AIM

To determine the physical activity level of the Croatian population in different domains of everyday life.

METHODS

A random stratified sample of 1032 Croatians aged 15 years and older was interviewed using the official Croatian long version of the International Physical Activity Questionnaire (IPAQ). Total physical activity and physical activity in each of the 4 life domains--work, transport, domestic and garden, and leisure-time--were estimated. Physical activity was expressed as metabolic equivalent-hours per week (MET-hour/week).

RESULTS

Median total physical activity for the whole sample was 58.2 MET-hour/week. Median physical activity in MET-hour/week was 30.4 for work, 5.0 for transportation, 13.1 for domestic and garden, and 6.0 for leisure-time domain. The lowest physical activity was found in the 15-24 age group (42.7 MET-hour/week) and the highest in the 55-64 age group (72.0 MET-hour/week). Multiple regression analysis showed a significant relationship of socio-demographic and health-related characteristics (size of settlements, household income, educational level, age, body mass index, self-rated physical health, and self-rated mental health) with physical activity in all domains (P < 0.001).

CONCLUSION

Studies on physical activity in transition countries should include the domains of work and domestic and garden, since if only leisure-time domain is examined, the total physical activity level could be underestimated. As the lowest physical activity was reported by adolescents and young adults, strategies for increasing physical activity in this age group should be developed.

Obesity prevalence from a European perspective: a systematic review

Background

Obesity has been recognised as an important contributing factor in the development of various diseases, but comparative data on this condition are limited. We therefore aimed to identify and discuss current epidemiological data on the prevalence of obesity in European countries.

Methods

We identified relevant published studies by means of a MEDLINE search (1990–2008) supplemented by information obtained from regulatory agencies. We only included surveys that used direct measures of weight and height and were representative of each country's overall population.

Results

In Europe, the prevalence of obesity (body mass index ≥ 30 kg/m²) in men ranged from 4.0% to 28.3% and in women from 6.2% to 36.5%. We observed considerable geographic variation, with prevalence rates in Central, Eastern, and Southern Europe being higher than those in Western and Northern Europe.

Conclusion

In Europe, obesity has reached epidemic proportions. The data presented in our review emphasise the need for effective therapeutic and preventive strategies.

Relationship between health-related fitness and educational and income levels in Spanish women

OBJECTIVES

The aim of this study was to determine whether a relationship exists between health-related fitness, taken as an indicator of regular physical activity, and educational and income levels in adult Spanish women.

STUDY DESIGN

Descriptive, correlation, cross-sectional study.

METHODS

A stepwise stratification procedure according to population size, age and level of physical activity according to a previous epidemiological survey was used for sampling. Two thousand and thirty-eight women gave their written consent to participate (62.8% of those invited). The final sample consisted of 1709 healthy women (aged 18-88 years). Subjects were categorized into high, medium and low level groups for education and income. All participants were assessed for morphological and physical health-related fitness. Three-way MANCOVA (age as covariate) and Bonferroni's post hoc test were used to determine the differences between groups.

RESULTS

No significant relationships were found between age-adjusted educational and income levels. The lowest values for health-related fitness were found in the lowest educational and income groups (P<0.001). The higher the level of education and income, the better the values for all fitness variables (P<0.001), except anterior trunk flexibility.

CONCLUSIONS

A positive relationship was found between health-related fitness and educational and income levels, which appeared to be most evident in the lowest educational and income groups. This implies that health-related promotion policies in Spain should stress the importance of regular physical activity in social classes with low levels of education and income.

The Relationship of Older Adults' Activities and Body Mass Index

Objectives: To investigate the relationship between Body Mass Index (BMI) and older adults' hours of participation in 31 activities. Methods: Descriptive statistics are presented for the relationships between BMI and sociodemographics, health behaviors, and health characteristics. Linear regression was used to model the number of hours of participation in each activity. Results: The hypothesis that being overweight or obese is associated with older adults' activities was supported. For example, compared to those of normal weight, obese older adults spend fewer hours walking, exercising, praying and meditating, house cleaning, and engaging in personal grooming. And, compared to normal weight older adults, obese older adults spend a greater number of hours watching television. Discussion: These results substantiate prior findings of a negative relationship between physical activity and excess weight, and the lack of a relationship between social activity and BMI.

Leisure time but not occupational physical activity significantly affects cardiovascular risk factors in an adult population

BACKGROUND

A large number of studies have demonstrated that regular physical activity during leisure time (LTPA) accounts for a significant protection against cardiovascular diseases (CVD). On the other hand, conflicting findings on the beneficial effects of occupational physical activity (OPA) have been reported. The aim of this study is to evaluate the possible influence of different amounts of LTPA and OPA on circulating levels of several parameters associated with an increased risk of CVD.

MATERIALS AND METHODS

We studied 932 individuals (365 M; 567 F, with a mean age of 54 years) living in Florence, Italy, who were enrolled in a population study conducted between 2002 and 2004. Subjects were divided into three classes of LTPA and OPA according to a score derived from a questionnaire that assessed the amount of physical activity performed.

RESULTS

LTPA was inversely related to body mass index (BMI), hip circumference, diastolic blood pressure and triglycerides, as well as directly correlated with high-density lipoprotein (HDL) cholesterol. Likewise, a higher OPA was found to be associated with higher HDL cholesterol levels. Moreover, a multivariate logistical regression analysis, adjusted for possible confounders, showed that a moderate-to-high intensity of LTPA was able to confer a significant protection against having abnormal levels of BMI, waist circumference and triglycerides, main features of the metabolic syndrome, whereas no associations between these parameters and OPA were observed.

CONCLUSIONS

A moderate-to-high LTPA was found to be significantly associated with a more favourable cardiovascular risk profile in terms of anthropometric, metabolic and lipid parameters among an Italian population. In addition, a relationship between OPA and HDL-cholesterol was reported.

Risk factors for overweight and obesity: results from the 2001 National Health Survey

OBJECTIVES

A significant rise in the proportion of overweight and obese adults has produced a serious health epidemic in Australia and worldwide. The current research aimed to identify sociodemographic and behavioural predictors of overweight and obesity among a large representative sample of Australian adults.

STUDY DESIGN

We used the National Health Survey conducted by the Australian Bureau of Statistics in 2001. The survey involved a stratified multistage area sample of private dwellings and face-to-face interviews.

METHODS

We analysed data from 8643 females and 7600 males who responded to the 2001 National Health Survey. Multinomial logistic regression examined the association of being overweight or obese versus a healthy weight with a range of sociodemographic and behavioural variables.

RESULTS

Fewer females than males were overweight while similar proportions were obese. For females and males, overweight and obesity were significantly associated with older age, being born in Australia, not being in a marriage-like relationship, low education, physical inactivity, and being a non/ex-smoker. High household incomes are protective from obesity but not from being overweight. Additionally, females with high levels of area social disadvantage and males in professional or white-collar occupations were more likely to be overweight or obese than a healthy weight.

CONCLUSIONS

Reductions in mortality and morbidity associated with overweight and obesity may be achieved by targeting health promotion strategies to high-risk groups such as those who are older, single, Australian born, socioeconomically disadvantaged, physically inactive, and non-smokers.

Longitudinal relationships between occupational and domestic physical activity patterns and body weight in China

OBJECTIVES

To examine the longitudinal relationship between occupational and domestic sources of physical activity and body weight in a sample of Chinese adults.

METHODS

Population-based longitudinal observational study of Chinese adults (4697 women and 4708 men) aged 18-55 from the 1991, 1993, 1997, and 2000 waves of the China Health and Nutrition Survey. Measured height and weight and detailed self-reported energy expenditure from multiple occupational and domestic sources were assessed over a 9-year period. Longitudinal relationships were modeled using linear random effects models.

RESULTS

Increased occupational physical activity resulted in overall lower body weight for both men and women (beta-coefficients (95% confidence interval (CI)) for high levels: -0.46 (-0.76, -0.15) for men, -0.36 (-0.62, -0.10) for women, and increased domestic physical activity resulted in overall lower body weight in men (beta-coefficient (95% CI): -0.40 (-0.62, -0.18)).

CONCLUSIONS

Physical activity that occurs in the occupational and domestic sectors is often overlooked; yet our research suggests they have important effects on body weight in Chinese adults. As China continues to urbanize, energy expenditure from these sources is decreasing, and our results point out the need to explore these types of physical activity more broadly across the world as potential sources of weight gain.

Lifestyle correlates of anthropometric estimates of body adiposity in an Italian middle-aged and elderly population: a covariance analysis

OBJECTIVE

To study the relationship between behavioural factors, body adiposity and muscle mass.

SUBJECTS AND METHODS

A total of 1415 Italian individuals (705 men and 710 women) aged 40-74 years from a population-based survey carried out in the town of Bollate (Milan). Analysis of covariance was used to refine and improve the precision of the comparisons.

RESULTS

Men: Smoking and sedentary behaviour were related to larger waist circumference (WC) and smaller hip circumference (HC). Increased WC was also associated with high-fat diet and moderate-to-heavy drinking (compared to light drinkers). Those more educated (completed high school) were leaner and ex-smokers had higher body mass index (BMI) than non-smokers. Women: BMI was inversely related with education, the more educated having also lower muscle mass. The light drinkers were leaner and moderate-to-heavy drinkers had less muscle mass than abstainers. Moderate-to-heavy drinkers had larger WC than light drinkers. A strong negative trend was found in the relationship between dietary fibre and WC. Overall adiposity (BMI) and, more weakly, HC and peripheral subcutaneous fat increased with more TV watching, whereas BMI lowered, together with WC and muscle mass (as measured by the mid-arm circumference), with more walking/cycling.

CONCLUSIONS

Modifiable habits such as smoking (men) and moderate-to-heavy alcohol drinking are associated with a pattern that is particularly deleterious to health: increased intra-abdominal fat and less muscle mass. Prevention strategies should be simultaneously aimed at promoting physical activities and reducing sedentary behaviours. A low-fat, fibre-rich diet seems to be closely related to a healthy distribution of body fat.

Leisure-time and occupational physical activity in relation to cardiovascular risk factors and eating habits in French adults

Objective

To investigate the relationships of two main physical activity domains (during leisure and at work) with cardiovascular risk factors and eating habits.

Design

Cross-sectional study.

Setting

Preventive medicine centre.

Subjects

In 5478 adults (32% women, aged 20–80 years) who consecutively underwent a standardised health examination, leisure-time physical activity (LTPA; i.e. non-sport leisure and sport activities), occupational physical activity (OPA) and eating habits were assessed by self-administered questionnaires. We analysed sex-specific relationships of LTPA and OPA (in quartiles) with (1) various cardiovascular risk factors and (2) eating habits using analysis of variance and logistic regression, respectively.

Results

In both genders, with and without adjustment for education in addition to age, LTPA was associated negatively with body mass index, body fat, waist circumference, resting heart rate, diastolic blood pressure and triglycerides, and positively associated with high-density lipoprotein cholesterol (all P ≤ 0.005). OPA adjusted for age only was positively associated with most cardiovascular risk factors but these associations were not significant after further adjustment on education (except for waist circumference in women). Age- and education-adjusted LTPA was associated with increased frequency of consumption of fruits (odds ratio (OR) = 2.05, 95% confidence interval (CI) 1.68–2.52 in men; OR = 1.90, 95% CI 1.41–2.05 in women) and vegetables (OR = 1.81, 95% CI 1.48–2.21 in men; OR = 2.22, 95% CI 1.66–2.97 in women).

Conclusions

The data emphasise the favourable associations of LTPA, a modifiable behaviour, with various cardiovascular risk factors and healthy eating habits. The results also suggest that the relationships of OPA with cardiovascular risk factors depend, at least in part, on socio-economic status as reflected by educational level.