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Validity of a short questionnaire to assess physical activity in 10 European countries
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
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2012 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 27, no 1, 15-25 p.Article in journal (Refereed) Published
Abstract [en]

To accurately examine associations of physical activity (PA) with disease outcomes, a valid method of assessing free-living activity is required. We examined the validity of a brief PA questionnaire (PAQ) used in the European Prospective Investigation into Cancer and Nutrition (EPIC). PA energy expenditure (PAEE) and time spent in moderate and vigorous physical activity (MVPA) was measured in 1,941 healthy individuals from 10 European countries using individually-calibrated combined heart-rate and movement sensing. Participants also completed the short EPIC-PAQ, which refers to past year's activity. Pearson (r) and Spearman (sigma) correlation coefficients were calculated for each country, and random effects meta-analysis was used to calculate the combined correlation across countries to estimate the validity of two previously- and one newly-derived ordered, categorical PA indices ("Cambridge index", "total PA index", and "recreational index") that categorized individuals as inactive, moderately inactive, moderately active, or active. The strongest associations with PAEE and MVPA were observed for the Cambridge index (r = 0.33 and r = 0.25, respectively). No significant heterogeneity by country was observed for this index (I-2 = 36.3%, P = 0.12; I-2 = 0.0%, P = 0.85), whereas heterogeneity was suggested for other indices (I-2 > 48%, P < 0.05, I-2 > 47%, P < 0.05). PAEE increased linearly across self-reported PA categories (P for trend < 0.001), with an average difference of approximately 460 kJ/d for men and 365 kJ/d for women, between categories of the Cambridge index. The EPIC-PAQ is suitable for categorizing European men and women into four distinct categories of overall physical activity. The difference in PAEE between categories may be useful when estimating effect sizes from observational research.

Place, publisher, year, edition, pages
Dordrecht: Springer Netherlands, 2012. Vol. 27, no 1, 15-25 p.
Keyword [en]
Physical activity, Validity, Self-report, Questionnaire, Accelerometry
National Category
Environmental Health and Occupational Health Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:umu:diva-53812DOI: 10.1007/s10654-011-9625-yISI: 000301184300003OAI: diva2:514019
Available from: 2012-04-04 Created: 2012-04-04 Last updated: 2012-04-04Bibliographically approved
In thesis
1. Validation and application of objective measures of obesity and physical activity: studies in pregnant and non-pregnant adults and in infants
Open this publication in new window or tab >>Validation and application of objective measures of obesity and physical activity: studies in pregnant and non-pregnant adults and in infants
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Validering och tillämpning av objektiva mätmetoder för obesitas och fysisk aktiviet : studier av gravida och icke-gravida vuxna och av spädbarn
Abstract [en]

Background Excess adipose tissue and low physical activity are two major determinants for chronic diseases such as type 2 diabetes and cardiovascular disease.  Understanding these relationships requires accurate and precise measures of body composition and physical activity, and most existing observational studies lack such measures. Paper I to III in this thesis addresses the validity of measures of physical activity and abdominal adipose mass. In paper IV and V, we explore the relationships between obesity and physical activity on metabolic health in non-pregnant and pregnant women and their offspring.

Methods and Results Two hundred men and women representative of the Northern Sweden EPIC cohort were recruited for Paper I. A questionnaire on physical activity (PAQ) was validated against objectively measured physical activity energy expenditure (PAEE). A categorical physical activity index (Cambridge index) calculated from PAQ showed strongest correlation with PAEE (r=0.33 p<0.05). In Paper II, abdominal adiposity were assessed in 29 adult men and women using anthropometric measurements, dual energy x-ray absorptiometry (DXA) and ultrasound and were compared to computed tomography (CT). Waist circumference showed the highest correlation with CT-assessed visceral (r=0.85, p<0.0001) and subcutaneous adipose tissue (r=0.86, p<0.0001). Adipose thickness was best assessed with ultrasound. In Paper III, the validity of a wrist-worn triaxial accelerometer was assessed in 32 pregnant and 74 non-pregnant women using double-labeled water method (DLW) as the criterion measure. The output from the accelerometer explained 24% (p <0.001) of the variation in PAEE in non-pregnant and 11% (p<0.05) in the pregnant women. In Paper IV, 35 pregnant and 73 non-pregnant women underwent a 75g oral glucose tolerance test and habitual energy expenditure and physical activity was assessed objectively. Total physical activity was inversely associated with early insulin response in both pregnant (r=-0.47, p=0.007) and non-pregnant (r=-0.36, p=0.004) women. In, Paper V, 32 women and their offspring (n=33) were studied 4 months post-partum. Body composition was quantified using DXA in the women and air-displacement plethysmography  in the infants. Mid-pregnancy weight gain was significantly associated with infant fat mass (r=0.41, p=0.022), whereas late-pregnancy weight gain associated to infant fat-free mass (r=0.37, p=0.04).

Conclusion This work describes new methods as well as conventional anthropometric estimates and a questionnaire, that provide relatively strong estimates of body composition and physical activity which could be used in larger studies. Pregnant women were shown to have more sedentary behavior than non-pregnant but physical activity appeared to have equal effect on glucose homeostasis in both groups, which may help guide lifestyle interventions in pregnancy. The impact of weight gain during the different trimesters seems to differentially affect the offspring’s body composition in early infancy, which might give us clues to when different aspects of fetal development and growth occur and how modifiable lifestyle behaviors might be intervened upon to improve long-term health.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2011. 110 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1422
physical activity, validation, body composition, abdominal adipose tissue, methods, accelerometer, pregnancy, insulin sensitivity, offspring
urn:nbn:se:umu:diva-43770 (URN)978-91-7459-216-0 (ISBN)
Public defence
2011-06-07, Bergasalen, Norrlands universitetssjukhus, Umeå, 09:00 (English)
EmbargoAvailable from: 2011-05-13 Created: 2011-05-09 Last updated: 2012-04-04Bibliographically approved

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