Measuring Physical Activity

Measuring Physical Activity http://www.participaction.com/wp-content/uploads/2012/09/The-January-Research-File_eng.pdf

Physical Activity Measurement http://www.researchgate.net/profile/Stephanie_Schoeppe/publication/6778339_Physical_activity_measurement–a_primer_for_health_promotion/links/02bfe511842852620a000000.pdf

Questionnaires

(These typically require participants to self-report their level of activity)

International Physical Activity Questionnaire (IPAQ) – short and long version, multiple languages https://sites.google.com/site/theipaq/questionnaire_links

Community Healthy Activities Model Program for Seniors (CHAMPS) – available in english and spanish http://dne2.ucsf.edu/public/champs/resources/qxn/

Global Physical Activity Questionnaire – available in multiple languages http://www.who.int/chp/steps/GPAQ/en/

Godin Leisure Time Exercise Questionnaire http://www.godin.fsi.ulaval.ca/Fichiers/Quest/Godin%20leisure-time.pdf

Tests

(These can be used to record a value to the activity level of participants)

6 Minute Walk Test http://www.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=895

Push up Test at Home (upper body strength) http://www.topendsports.com/testing/tests/home-pushup.htm

Squat Test at Home (lower body strength) http://www.topendsports.com/testing/tests/home-squat.htm

Sit and Reach Flexibility Test at Home http://www.topendsports.com/testing/tests/home-sit-and-reach.htm

Shoulder Reach Flexibility Test http://www.topendsports.com/testing/tests/shoulder-flexibility.htm

Rehabilitation Measures Database (some tests may be beyond scope of course project) http://www.rehabmeasures.org/default.aspx

Readings

Series on Physical Activity ★ Recommended by Dr. Steven Blair
http://www.thelancet.com/series/physical-activity
Note: Articles in the Series on Physical Activity are available free of charge if you create a username and password.

Energy Balance Basics
http://www.gebn.org/energy-balance-basics

Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults
http://www.ncbi.nlm.nih.gov/books/NBK2003/

Physical activity and health – A Report of the Surgeon General
http://www.cdc.gov/nccdphp/sgr/index.htm

Exercise & Physical Activity: Your Everyday Guide from the National Institute on Aging
http://www.nia.nih.gov/health/publication/exercise-physical-activity/20-frequently-asked-questions

Physical Activity Guidelines for Americans
http://www.health.gov/paguidelines/guidelines/summary.aspx

Examining The Use of Evidence Based and Social Media Supported Tools in Freely Acessible Physical Activity Internvetion Websites
http://www.researchgate.net/publication/264795563_Examining_the_use_of_evidence-based_and_social_media_supported_tools_in_freely_accessible_physical_activity_intervention_websites

Tools, Calculators and Resources

American Council on Exercise
http://www.acefitness.org/acefit/tools-and-calculators/

Centers for Disease Control & Prevention – Benefits of Physical Activity
http://www.cdc.gov/physicalactivity/everyone/health/index.html?s_cid=cs_284

How fast does the Grim Reaper walk?

BMJ. 2011 Dec 15;343:d7679. doi: 10.1136/bmj.d7679.

How fast does the Grim Reaper walk? Receiver operating characteristics curve analysis in healthy men aged 70 and over.

Abstract

OBJECTIVE:

To determine the speed at which the Grim Reaper (or Death) walks.

DESIGN:

Population based prospective study.

SETTING:

Older community dwelling men living in Sydney, Australia.

PARTICIPANTS:

1705 men aged 70 or more participating in CHAMP (Concord Health and Ageing in Men Project).

MAIN OUTCOME MEASURES:

Walking speed (m/s) and mortality. Receiver operating characteristics curve analysis was used to calculate the area under the curve for walking speed and determine the walking speed of the Grim Reaper. The optimal walking speed was estimated using the Youden index (sensitivity + specificity-1), a common summary measure of the receiver operating characteristics curve, and represents the maximum potential effectiveness of a marker.

RESULTS:

The mean walking speed was 0.88 (range 0.15-1.60) m/s. The highest Youden index (0.293) was observed at a walking speed of 0.82 m/s (2 miles (about 3 km) per hour), corresponding to a sensitivity of 63% and a specificity of 70% for mortality. Survival analysis showed that older men who walked faster than 0.82 m/s were 1.23 times less likely to die (95% confidence interval 1.10 to 1.37) than those who walked slower (P = 0.0003). A sensitivity of 1.0 was obtained when a walking speed of 1.36 m/s (3 miles (about 5 km) per hour) or greater was used, indicating that no men with walking speeds of 1.36 m/s or greater had contact with Death.

CONCLUSION:

The Grim Reaper’s preferred walking speed is 0.82 m/s (2 miles (about 3 km) per hour) under working conditions. As none of the men in the study with walking speeds of 1.36 m/s (3 miles (about 5 km) per hour) or greater had contact with Death, this seems to be the Grim Reaper’s most likely maximum speed; for those wishing to avoid their allotted fate, this would be the advised walking speed.

Global health risks

A response to the need for comprehensive, consistent and comparable information on health risks at global and regional level.

Global health risks is a comprehensive assessment of leading risks to global health. It provides detailed global and regional estimates of premature mortality, disability and loss of health attributable to 24 global risk factors.

Physical activity

The Benefits of Physical Activity

Regular physical activity is one of the most important things you can do for your health. It can help:

If you’re not sure about becoming active or boosting your level of physical activity because you’re afraid of getting hurt, the good news is that moderate-intensity aerobic activity, like brisk walking, is generally safe for most people.


Fact sheet N°385
Updated January 2015

Key facts

  • Insufficient physical activity is 1 of the 10 leading risk factors for death worldwide.
  • Insufficient physical activity is a key risk factor for noncommunicable diseases (NCDs) such as cardiovascular diseases, cancer and diabetes.
  • Physical activity has significant health benefits and contributes to prevent NCDs.
  • Globally, 1 in 4 adults is not active enough.
  • More than 80% of the world’s adolescent population is insufficiently physically active.
  • Policies to address insufficient physical activity are operational in 56% of WHO Member States.
  • WHO Member States have agreed to reduce insufficient physical activity by 10% by 2025.

What is physical activity?

WHO defines physical activity as any bodily movement produced by skeletal muscles that requires energy expenditure – including activities undertaken while working, playing, carrying out household chores, travelling, and engaging in recreational pursuits.

The term “physical activity” should not be confused with “exercise”, which is a subcategory of physical activity that is planned, structured, repetitive, and aims to improve or maintain one or more components of physical fitness. Both, moderate and vigorous intensity physical activity brings health benefits.

How much of physical activity is recommended?

WHO recommends:

Children and adolescents aged 5-17years
  • Should do at least 60 minutes of moderate to vigorous-intensity physical activity daily.
  • Physical activity of amounts greater than 60 minutes daily will provide additional health benefits.
  • Should include activities that strengthen muscle and bone, at least 3 times per week.
Adults aged 18–64 years
  • Should do at least 150 minutes of moderate-intensity physical activity throughout the week, or do at least 75 minutes of vigorous-intensity physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity.
  • For additional health benefits, adults should increase their moderate-intensity physical activity to 300 minutes per week, or equivalent.
  • Muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week.
Adults aged 65 years and above
  • Should do at least 150 minutes of moderate-intensity physical activity throughout the week, or at least 75 minutes of vigorous-intensity physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity.
  • For additional health benefits, they should increase moderate intensity physical activity to 300 minutes per week, or equivalent.
  • Those with poor mobility should perform physical activity to enhance balance and prevent falls, 3 or more days per week.
  • Muscle-strengthening activities should be done involving major muscle groups, 2 or more days a week.

The intensity of different forms of physical activity varies between people. In order to be beneficial for cardiorespiratory health, all activity should be performed in bouts of at least 10 minutes duration.

Benefits of physical activity and risk of insufficient physical activity

Regular physical activity of moderate intensity – such as walking, cycling, or doing sports – has significant benefits for health. At all ages, the benefits of being physically active outweigh potential harm, for example through accidents. Some physical activity is better than doing none. By becoming more active throughout the day in relatively simple ways, people can quite easily achieve the recommended activity levels.

Regular and adequate levels of physical activity:

  • improve muscular and cardiorespiratory fitness;
  • improve bone and functional health;
  • reduce the risk of hypertension, coronary heart disease, stroke, diabetes, breast and colon cancer and depression;
  • reduce the risk of falls as well as hip or vertebral fractures; and
  • are fundamental to energy balance and weight control.

Insufficient physical activity is 1 of the 10 leading risk factors for global mortality and is on the rise in many countries, adding to the burden of NCDs and affecting general health worldwide. People who are insufficiently active have a 20% to 30% increased risk of death compared to people who are sufficiently active.

Levels of insufficient physical activity

Globally, around 23% of adults aged 18 and over were not active enough in 2010 (men 20% and women 27%). In high-income countries, 26% of men and 35% of women were insufficiently physically active, as compared to 12% of men and 24% of women in low-income countries. Low or decreasing physical activity levels often correspond with a high or rising gross national product. The drop in physical activity is partly due to inaction during leisure time and sedentary behaviour on the job and at home. Likewise, an increase in the use of “passive” modes of transportation also contributes to insufficient physical activity.

Globally, 81% of adolescents aged 11-17 years were insufficiently physically active in 2010. Adolescent girls were less active than adolescent boys, with 84% vs. 78% not meeting WHO recommendations.

Several environmental factors which are linked to urbanization can discourage people from becoming more active, such as:

  • fear of violence and crime in outdoor areas
  • high-density traffic
  • low air quality, pollution
  • lack of parks, sidewalks and sports/recreation facilities.

How to increase physical activity?

Both, society in general and individuals can take action to increase physical activity. In 2013, WHO Member States agreed to a target of reducing insufficient physical activity by 10% by 2025 and included strategies to achieve such in the “Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020”.

Policies to increase physical activity aim to ensure that:

  • in cooperation with relevant sectors physical activity is promoted through activities of daily living;
  • walking, cycling and other forms of active transportation are accessible and safe for all;
  • labour and workplace policies encourage physical activity;
  • schools have safe spaces and facilities for students to spend their free time actively;
  • quality physical education supports children to develop behaviour patterns that will keep them physically active throughout their lives; and
  • sports and recreation facilities provide opportunities for everyone to do sports.

Policies and plans to address physical inactivity have been developed in about 80% of WHO Member States, though these were operational in only 56% of the countries in 2013. National and local authorities are also adopting policies in a range of sectors to promote and facilitate physical activity.

The paleo diet

Published on Feb 12, 2013
TED Fellow Christina Warinner is an expert on ancient diets. So how much of the diet phad the “Paleo Diet” is based on an actual Paleolithic diet? The answer is not really any of it.

Dr. Christina Warinner has excavated around the world, from the Maya jungles of Belize to the Himalayan mountains of Nepal, and she is pioneering the biomolecular investigation of archaeological dental calculus (tartar) to study long-term trends in human health and diet. She is a 2012 TED Fellow, and her work has been featured in Wired UK, the Observer, CNN.com, Der Freitag, and Sveriges TV. She obtained her Ph.D. from Harvard University in 2010, specializing in ancient DNA analysis and paleodietary reconstruction.


Off the Mark” by Mark J. Smith, Ph.D. – May 12, 2013


The paleo diet is based on emulating the diet of our hunter-gatherer ancestors. It includes whole, unprocessed foods that resemble what they look like in nature.

Our ancestors were genetically the same as modern humans. They thrived eating such foods and were free of diseases like obesity, diabetes and heart disease.

Several studies suggest that this diet can lead to significant weight loss (without calorie counting) and major improvements in health.

There is no one “right” way to eat for everyone and paleolithic humans thrived on a variety of diets, depending on what was available at the time.

Some ate a low-carb diet high in animal foods, others a high-carb diet with lots of plants.

Eat: Meat, fish, eggs, vegetables, fruits, nuts, seeds, herbs, spices, healthy fats and oils.

Avoid: Processed foods, sugar, soft drinks, grains, most dairy products, legumes, artificial sweeteners, vegetable oils, margarine and trans fats.

In the year 2013, the paleo diet was the world’s most popular diet.

However, it is still very controversial among health professionals and mainstream nutrition organizations.

Some have embraced the diet as healthy and reasonable, while others think it is downright harmful.

1. Lindeberg S, et al. A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia, 2007.

Details: 29 men with heart disease and elevated blood sugars or type 2 diabetes, were randomized to either a paleolithic diet (n=14) or a Mediterranean-like diet (n=15). Neither group was calorie restricted.

The main outcomes measured were glucose tolerance, insulin levels, weight and waist circumference. This study went on for 12 weeks.

Glucose Tolerance: The glucose tolerance test measures how quickly glucose is cleared from the blood. It is a marker for insulin resistance and diabetes.

This graph shows the difference between groups. The solid dots are the baseline, the open dots are after 12 weeks on the diet. Paleo group is on the left, control group on the right.

Lindeberg, et al. 2007.

As you can clearly see from the graphs, only the paleo diet group saw a significant improvement in glucose tolerance.

Weight Loss: Both groups lost a significant amount of weight, 5 kg (11 lbs) in the paleo group and 3.8 kg (8.4 lbs) in the control group. However, the difference was not statistically significant between groups.

The paleo diet group had a 5.6 cm (2.2 inches) reduction in waist circumference, compared to 2.9 cm (1.1 inches) in the control group. The difference was statistically significant.

A few important points:

    • The 2-hour Area Under the Curve (AUC) for blood glucose went down by 36% in the paleo group, compared to 7% in the control group.
    • Every patient in the paleo group ended up having normal blood sugars, compared to 7 of 15 patients in the control group.
  • The paleo group ended up eating 451 fewer calories per day (1344 compared to 1795) without intentionally restricting calories or portions.

Conclusion: A paleolithic diet lead to greater improvements in waist circumference and glycemic control, compared to a Mediterranean-like diet.


TUESDAY, JUNE 14, 2011

Farewell To “Paleo”

I have experimented with eating a so-called “paleo” diet for at least 14 years.  Although I had confidence enough in the concept to invest in self-publishing a book on putting it into practice, over this time I have endured increasing cognitive dissonance because the currently popular concept of paleo diet—animal-based, relatively high in protein and fat and relatively low in carbohydrate—conflicts with empirical nutrition knowledge accumulated over the course of 5 thousand years in both Asian and Western medicine, including a rather large body of clinical and laboratory data accumulated since the 19thcentury, all pointing toward humans being more adapted to a plant-dominated, high-carbohydrate diet supplying significantly less than 30% of energy from fat.