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Objectives: The aim of the study was to examine the relationship between employment status and job activity level with physical activity (PA) and sedentary time, stratified by gender and country., Design: Cross-sectional study design., Methods: Data from working age adults (18-65 years) from two cross-sectional studies, the Swedish 2001-2002 and 2007-2008 Attitude Behavior and Change Study (ABC; n=1165) and the 2003-2006 US National Health and Nutrition Examination Survey (NHANES; n=4201), were stratified by employment status (employed and not employed) and job activity level (active, sedentary and mixed). PA in counts×min(-1) and time spent in sedentary, low and moderate or higher intensity were measured with accelerometers. Analyses were conducted in 2012-2013., Results: In NHANES, the employed had significantly higher counts×min(-1) and spent more time in moderate or higher intensity PA than those not employed. In ABC, no significant differences were observed between employed and unemployed. Adults with active versus sedentary occupations had higher counts×min(-1) and less sedentary time in both the USA and Sweden and in both men and women. For example, counts×min(-1) were 20-40% greater in active versus sedentary jobs., Conclusions: Employment status is related to PA and sedentary time among men and women in the USA but not in Sweden. Among the employed, occupational PA is associated with total PA and sedentary time for both genders and in both countries. Comparisons of PA levels based on objective measurements can refine understanding of country differences in activity., (Copyright © 2015 Sports Medicine Australia. All rights reserved.)

Objective: To assess the relationships among physical activity, measured objectively, and attention capacity in European adolescents., Study Design: The study included 273 adolescents, aged 12.5-17.5 years, who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence Study. Participants wore a uniaxial accelerometer for 7 days to measure physical activity. The d2 Test of Attention was administered to assess attention capacity. Multivariate analyses were used to study the association of attention capacity with each measure of physical activity. Receiver operating characteristic analysis was performed to determine thresholds that best discriminate between low and good attention capacity., Results: After controlling for potential confounding variables (age, sex, body mass index, parental educational level, fat mass, aerobic fitness, and center), adolescents' attention capacity test performances were significantly and positively associated with longer time spent in moderate or moderate-to-vigorous physical activity (MVPA) in free-living conditions (P < .05). Receiver operating characteristic curve analyses revealed that the physical activity thresholds that best discriminated between low/good attention capacities were ≥41 min·day(-1) for moderate, ≥12 min·day(-1) for vigorous, and ≥58 min·day(-1) for MVPA., Conclusion: These findings suggest that promoting MVPA may be have a beneficial effect on attention capacity, an important component of cognition, in adolescents., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objectives: The aim of this study was to investigate changes over six years in physical activity and sedentary behavior assessed with accelerometry in a representative sample of Swedish adults., Design: A longitudinal study over six years., Methods: The cohort consisted of 1172 participants (46% males) in 2002 and 511 participants (46% males) in 2008, of which 478 (45% males) had valid data on both occasions. Mean (SD) age at baseline was 45 (15) years. To analyze changes over time, a mixed linear model for average intensity physical activity (counts/min) and time in sedentary behavior and light- and moderate- or higher-intensity physical activity was conducted, stratified for sex and age, and adjusted for BMI, education, self-rated health and Δ wear time., Results: Over a six year period no significant changes were seen in the total cohort for average intensity and time in moderate- or higher intensity physical activity. A significant decrease in average intensity physical activity was found for men (p=0.006) and those aged 60+ years at baseline (p<0.001). A significant increase (26 min/day) for sedentary time in the total cohort (p<0.001) and for time in moderate or higher intensity physical activity among women (p<0.001) and those aged 40-59 years at baseline (p=0.014) was found over the follow-up period., Conclusions: The overall increase in sedentary time and decrease in average physical activity among men and the elderly are of concern, since they might result in an elevated risk of developing chronic diseases., (Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

In this study, the association between physical activity and other potential determinants, objectively measured by accelerometry, was examined. Sixty-two men attending an infertility clinic participated in the study. Obese men (body mass index ≥ 30) and those with a waist circumference 102 cm or more had lower semen volume than the other men (P < 0.05). Higher values in sperm parameters were observed in participants who completed university studies and those who did not consume snuff, compared with the other participants (P < 0.05). Finally, men who spent an average number of 10 min-bouts of moderate-to-vigorous physical activity had significantly better semen quality than those who engaged in low or high numbers of bouts of activity (P < 0.05). No associations were found for sedentary or moderate-to-vigorous physical activity time when it was not sustained over 10 min, i.e. not in bouts. Men who have average levels of physical activity over sustained periods of 10 min are likely to have better semen quality than men who engage in low or high levels of such activity. Similarly, high levels of total and central adiposity, low educational level and snuff consumption are negatively related to semen quality., (Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)

Background/objective: Increased physical activity (PA) and decreased sedentary behaviors (SBs) may have beneficial effects on cardio-metabolic risk in adolescents. The aim of this study was to examine the associations between independent/combined effects of PA and SB with individual/clustered cardio-metabolic risk factors., Methods: A sample of 769 adolescents (12.5-17.5 years) from the HELENA cross-sectional study (Healthy Lifestyle in Europe by Nutrition in Adolescence) and with valid data on metabolic risk factors were included., Results: Concerning moderate-to-vigorous-PA (MVPA) and vigorous-PA (VPA), measured with accelerometers, girls tended to do more MVPA (36%) and VPA (114%) than boys. Unadjusted analyses show a positive association between "PA ≥ 60 min/d; SB ≥ 2 h" and the ratio TC/HDL-c (β = 0.27; 95%CI 0.01 to 0.52; p < 0.05), and a negative association between "MVPA ≥ 60 min/d; SB < 2h" with the ∑ 4Skinfolds (β = -0.32; 95%CI -0.61 to -0.02; p<0.05). Moreover, "SB ≥ 2 h/d" was associated with increased cardio-metabolic risk (PR 1.59; 95%CI 1.05 to 2.39; p < 0.05), while "PA ≥ 60 min/d; SB < 2h" had a protective effect against cardio-metabolic risk (PR 0.48; 95%CI 0.25 to 0.91; p < 0.05). After adjustment for potential confounders, a positive association between SB and ∑ 4Skinfolds was shown (β = 0.28; 95%CI 0.04 to 0.53; p < 0.05). Furthermore, VO2max (mL/kg/min) tends to increase in those participants who do higher VPA and less SB (p = 0.042), and there was a protective effect of "VPA ≥ 30 min/d; SB < 2h" against cardio-metabolic risk (PR 0.24; 95%CI 0.07 to 0.85; p < 0.05)., Conclusion: The current study suggests that adolescents should be encouraged to decrease sedentary lifestyle and increase physical activity, especially vigorous physical activity, in order to reduce cardio-metabolic risk., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Objective: To examine the association of breakfast consumption with objectively measured and self-reported physical activity, sedentary time and physical fitness., Design: The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Cross-Sectional Study. Breakfast consumption was assessed by two non-consecutive 24 h recalls and by a 'Food Choices and Preferences' questionnaire. Physical activity, sedentary time and physical fitness components (cardiorespiratory fitness, muscular fitness and speed/agility) were measured and self-reported. Socio-economic status was assessed by questionnaire., Setting: Ten European cities., Subjects: Adolescents (n 2148; aged 12·5-17·5 years)., Results: Breakfast consumption was not associated with measured or self-reported physical activity. However, 24 h recall breakfast consumption was related to measured sedentary time in males and females; although results were not confirmed when using other methods to assess breakfast patterns or sedentary time. Breakfast consumption was not related to muscular fitness and speed/agility in males and females. However, male breakfast consumers had higher cardiorespiratory fitness compared with occasional breakfast consumers and breakfast skippers, while no differences were observed in females. Overall, results were consistent using different methods to assess breakfast consumption or cardiorespiratory fitness (all P ≤ 0·005). In addition, both male and female breakfast skippers (assessed by 24 h recall) were less likely to have high measured cardiorespiratory fitness compared with breakfast consumers (OR = 0·33; 95% CI 0·18, 0·59 and OR = 0·56; 95%CI 0·32, 0·98, respectively). Results persisted across methods., Conclusions: Skipping breakfast does not seem to be related to physical activity, sedentary time or muscular fitness and speed/agility as physical fitness components in European adolescents; yet it is associated with both measured and self-reported cardiorespiratory fitness, which extends previous findings.

Background: To examine the association between physical activity (PA) and liver enzyme levels in adolescents from nine European countries., Methods: The study comprised 718 adolescents (397 girls). PA was measured by accelerometry and expressed as total PA (counts/min), and time (min/d) engaged in moderate to vigorous intensity PA (MVPA). Time spent sedentary was also objectively measured. We measured serum levels of alanine aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyltransferase (GGT), and the AST/ALT ratio was computed., Results: There was an association between MVPA and AST and AST/ALT (age, sex, and center-adjusted β = 0.096, 95% confidence interval (CI): 0.016 to 0.118; and β = 0.090, 95% CI: 0.006 to 0.112, respectively). Meeting the PA recommendations (60 min/d of MVPA) was significantly associated with higher AST and AST/ALT, which persisted after further adjusting for sedentary time and waist circumference. Sedentary time was not associated with any of the studied liver enzyme levels., Conclusion: Meeting the current PA recommendations of 60 min/d of MVPA is associated with higher levels of AST and AST/ALT regardless of time spent sedentary as well as total and central body fat in European adolescents.

To investigate the combined influence of diet quality and physical activity on cardiovascular disease (CVD) risk factors in adolescents, adolescents (n = 1513; 12.5-17.5 years) participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence study were studied. Dietary intake was registered using a 24-h recall and a diet quality index was calculated. Physical activity was assessed by accelerometry. Lifestyle groups were computed as: healthy diet and active, unhealthy diet but active, healthy diet but inactive, and unhealthy diet and inactive. CVD risk factor measurements included cardiorespiratory fitness, adiposity indicators, blood lipid profile, blood pressure, and insulin resistance. A CVD risk score was computed. The healthy diet and active group had a healthier cardiorespiratory profile, fat mass index (FMI), triglycerides, and high-density lipoprotein cholesterol (HDL-C) levels and total cholesterol (TC)/HDL-C ratio (all P ≤ 0.05). Overall, active adolescents showed higher cardiorespiratory fitness, lower FMI, TC/HDL-C ratio, and homeostasis model assessment index and healthier blood pressure than their inactive peers with either healthy or unhealthy diet (all P ≤ 0.05). Healthy diet and active group had healthier CVD risk score compared with the inactive groups (all P ≤ 0.02). Thus, a combination of healthy diet and active lifestyle is associated with decreased CVD risk in adolescents. Moreover, an active lifestyle may reduce the adverse consequences of an unhealthy diet., (© 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: Coordinated European projects relying on standardized methods are needed to identify health inequalities across Europe. This study aimed to compare fitness, fatness, and cardiometabolic risk between urban adolescents from the south and center-north of Europe and to explore whether physical activity (PA) and other factors might explain these differences., Methods: The Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional project comprised 3528 adolescents from the south (4 cities) and central-north (6 cities) of Europe, 1089 of whom provided blood samples for analysis. Fitness (strength, speed-agility, and cardiorespiratory fitness), total and abdominal fatness (anthropometry and bioelectrical impedance), and cardiometabolic risk (z scores including fitness, fatness, blood lipids, insulin resistance, and blood pressure) were assessed. The analyses were adjusted for socioeconomic factors, objectively measured PA (accelerometry), total energy intake and diet quality, and genetic variants of the FTO rs9939609 polymorphism., Results: Adolescents from southern Europe were less fit and fatter according to all markers (P < .001). Differences in cardiometabolic risk scores were not consistent. Adolescents from the south were less active and this would largely explain the differences observed in speed-agility and cardiorespiratory fitness. Differences in total and abdominal fatness could not be explained by PA, energy intake, diet quality, or FTO rs9939609 polymorphism., Conclusions: Fitness and fatness levels indicate that urban adolescents from the south are less healthy than those from central-northern Europe. Our data suggest that differences in PA might explain differences in important health-related fitness components, yet factors explaining the differences in fatness encountered remain unknown.

Objective: To test whether youths who engage in vigorous physical activity are more likely to have lean bodies while ingesting relatively large amounts of energy. For this purpose, we studied the associations of both physical activity and adiposity with energy intake in adolescents., Study Design: The study subjects were adolescents who participated in 1 of 2 cross-sectional studies, the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study (n = 1450; mean age, 14.6 years) or the European Youth Heart Study (EYHS; n = 321; mean age, 15.6 years). Physical activity was measured by accelerometry, and energy intake was measured by 24-hour recall. In the HELENA study, body composition was assessed by 2 or more of the following methods: skinfold thickness, bioelectrical impedance analysis, plus dual-energy X-ray absorptiometry or air-displacement plethysmography in a subsample. In the EYHS, body composition was assessed by skinfold thickness., Results: Fat mass was inversely associated with energy intake in both studies and using 4 different measurement methods (P ≤ .006). Overall, fat-free mass was positively associated with energy intake in both studies, yet the results were not consistent across measurement methods in the HELENA study. Vigorous physical activity in the HELENA study (P < .05) and moderate physical activity in the EYHS (P < .01) were positively associated with energy intake. Overall, results remained unchanged after adjustment for potential confounding factors, after mutual adjustment among the main exposures (physical activity and fat mass), and after the elimination of obese subjects, who might tend to underreport energy intake, from the analyses., Conclusion: Our data are consistent with the hypothesis that more physically active and leaner adolescents have higher energy intake than less active adolescents with larger amounts of fat mass., (Copyright © 2014 Mosby, Inc. All rights reserved.)

Objective: To explore the clustering of different lifestyle behaviors and whether this clustering differs by gender, age, and health-related fitness., Design: Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study., Setting: Ten European cities., Participants: A total of 2,084 adolescents (12.5-17.5 years)., Main Outcome Measures: Four lifestyle behaviors were assessed by self-administered questionnaires: moderate to vigorous physical activity, homework time, screen time, and diet. Health-related fitness components (aerobic capacity, strength, speed-agility, and body composition) were assessed., Analysis: Hierarchical method and κ-means cluster analysis. Analysis of variance tests., Results: Five clusters were identified: Healthy diet and Active, Healthy diet and Academic, Healthy diet and Inactive, Unhealthy diet and Screen user, and Unhealthy diet and Active. Younger adolescents were more active and followed a healthier diet than older adolescents. Older boys devoted more time to screen use, whereas older girls devoted more time to homework. Boys in the Healthy diet and Active cluster presented higher aerobic capacity and speed-agility, whereas girls presented higher aerobic capacity, strength, and speed-agility., Conclusions and Implications: Clustering of different lifestyle behaviors is observed. Different healthy lifestyles do not always come together and clusters are associated with gender, age, and health-related fitness, but not with body composition. These differences need to be considered when developing intervention strategies for the prevention of unhealthy habits., (Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Background: Physical activity (PA) is suggested to contribute to fat loss not only through increasing energy expenditure "per se" but also increasing muscle mass; therefore, it would be interesting to better understand the specific associations of PA with the different body's components such as fat mass and muscle mass. The aim of the present study was to examine the association between objectively measured PA and indices of fat mass and muscle components independently of each other giving, at the same time, gender-specific information in a wide cohort of European adolescents., Methods: A cross-sectional study in a school setting was conducted in 2200 (1016 males) adolescents (14.7 ± 1.2 years). Weight, height, skinfold thickness, bioimpedance and PA (accelerometry) were measured. Indices of fat mass (body mass index, % fat mass, sum of skinfolds) and muscular component (assessed as fat-free mass) were calculated. Multiple regression analyses were performed adjusting for several confounders including fat-free mass and fat mass when possible., Results: Vigorous PA was positively associated with height (p<0.05) in males, whilst, vigorous PA, moderate-vigorous PA and average PA were negatively associated with all the indices of fat mass (all p<0.01) in both genders, except for average PA in relation with body mass index in females. Regarding muscular components, vigorous PA showed positive associations with fat-free mass and muscle mass (all p<0.05) in both genders. Average PA was positively associated with fat-free mass (both p<0.05) in males and females., Conclusion: The present study suggests that PA, especially vigorous PA, is negatively associated with indices of fat mass and positively associated with markers of muscle mass, after adjusting for several confounders (including indices of fat mass and muscle mass when possible). Future studies should focus not only on the classical relationship between PA and fat mass, but also on PA and muscular components, analyzing the independent role of both with the different PA intensities.

Objective: To analyze the association between objectively assessed physical activity (PA) and markers of insulin resistance (IR) in European adolescents and to examine whether the association of objectively assessed PA and markers of IR is modified by cardiorespiratory fitness (CRF)., Methods: A cross-sectional study at school setting was conducted in 1053 (554 girls) adolescents (12.5-17.5 yr). Weight, height, waist circumference, total body fat, PA (accelerometry), and CRF (20-m shuttle run test) were measured. Fasting insulin and glucose concentrations were measured, and homeostasis model assessment as well as quantitative insulin sensitivity check index were computed., Results: In males, vigorous PA (VPA) was negatively associated with markers of IR after adjusting for confounders including waist circumference (all p < 0.05). In females, moderate PA, moderate to vigorous PA, and average PA were negatively associated with markers of IR after adjusting for confounders (all p < 0.05). Moreover, when the sample was segmented by CRF levels all the PA intensities were significantly associated with the markers of IR in females with low CRF but not in those with middle-high CRF after adjusting for confounders., Conclusions: The findings suggest that PA is negatively associated with markers of IR after adjusting for confounders including total and central body fat in both sexes, but this relationship is modified by the CRF levels being especially important in those females with low CRF. Preventive strategies should focus not only on increasing the volume of PA but also on enhancing CRF through VPA., (© 2013 John Wiley & Sons A/S.)

Background: To know how moderate-to-vigorous physical activity (MVPA) and sedentary time change across lifespan periods is needed for designing successful lifestyle interventions. We aimed to study changes in objectively measured (accelerometry) MVPA and sedentary time from childhood to adolescence and from adolescence to young adulthood., Methods: Estonian and Swedish participants from the European Youth Heart Study aged 9 and 15 years at baseline (N = 2312) were asked to participate in a second examination 6 (Sweden) to 9/10 (Estonia) years later. 1800 participants with valid accelerometer data were analyzed., Results: MVPA decreased from childhood to adolescence (-1 to -2.5 min/d per year of follow-up, P = 0.01 and <0.001, for girls and boys respectively) and also from adolescence to young adulthood (-0.8 to -2.2 min/d per year, P = 0.02 and <0.001 for girls and boys, respectively). Sedentary time increased from childhood to adolescence (+15 and +20 min/d per year, for girls and boys respectively, P<0.001), with no substantial change from adolescence to young adulthood. Changes in both MVPA and sedentary time were greater in Swedish than in Estonian participants and in boys than in girls. The magnitude of the change observed in sedentary time was 3-6 time larger than the change observed in MVPA., Conclusions: The decline in MVPA (overall change = 30 min/d) and increase sedentary time (overall change = 2:45 h/d) observed from childhood to adolescence are of concern and might increase the risk of developing obesity and other chronic diseases later in life. These findings substantially contribute to understand how key health-related behaviors (physical activity and sedentary) change across important periods of life.

We examined whether physical activity (PA) influences the association between birth weight and serum leptin in adolescents. The study comprised a total of 538 adolescents (315 girls), aged 12.5-17.49 years, born at term (≥ 37 weeks of gestation). We measured serum leptin levels and time engaged in moderate-vigorous PA (MVPA) by accelerometry. There was an interaction effect between birth weight and meeting the PA recommendations (60 min/day MVPA) on leptin levels in girls (P = 0.023) but not in boys (P = 0.809). Birth weight was negatively associated with leptin levels in girls not meeting the PA recommendations (i.e. more than 60 min/day of MVPA) (β = -0.096, P = 0.009), whereas no significant association was observed in those meeting the PA recommendations (β = -0.061, P = 0.433). In conclusion, meeting the PA recommendations may attenuate the negative effect of low birth weight on serum leptin levels in European female adolescents., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Objective: This study aimed to examine the association of television (TV) time, the frequency of meals while watching TV and the presence of TV set in the bedroom with total and abdominal obesity and to assess whether physical activity (PA) attenuates the obesity risk of TV viewing., Methods: Cross-sectional data were obtained from 2200 adolescents (46% boys) from 10 European cities, The Healthy Lifestyle in Europe by Nutrition in Adolescence study, between 2006 and 2007. TV viewing, PA (by accelerometry) and body composition were measured. Binary logistic regression analyses were performed., Results: Even adjusting by vigorous PA, TV in the bedroom (odds ratio [OR]: 1.33, 95% confidence interval [CI], 1.01-1.74) and >4 h d(-1) TV during week days (OR: 1.30, 95% CI, 1.02-1.67) (in boys) and eating every day with TV (OR: 1.18, 95% CI, 1.07-1.30) and >2 h d(-1) TV during weekend days (OR: 1.68, 95% CI, 1.25-2.26) (in girls) were significantly associated with total obesity. Likewise, in both sexes, having a TV set at bedroom was significantly associated with abdominal obesity., Conclusions: Adolescents spending excessive TV time are prone to obesity independently of their PA levels. Families should put TV sets out of adolescents' bedroom and keep TV sets off during meal times., (© 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.)

Objective: Atherogenesis involves an inflammatory process that occurs early in life even though clinical symptoms are not observed until adulthood. Two important protective factors for low-grade inflammation may be physical activity (PA) and fitness. We examined the independent associations of objective and subjective measurements of PA and fitness with low-grade inflammation in European adolescents., Methods: A total of 1045 adolescents, aged from 12.5 to 17.5 years old from 10 European cities, were selected from the HELENA-Cross-Sectional Study. Objectively-measured and self-reported PA variables were obtained by accelerometry and the International PA Questionnaire for Adolescents, respectively. Overall, cardiorespiratory, muscular and motor fitness variables were assessed by standardized field-based fitness tests and the International Fitness Scale. C-reactive protein (CRP), complement factors 3 (C3) and 4 (C4), interleukin-6 and TNF-α inflammatory markers were measured., Results: Objectively-measured vigorous PA was inversely associated with C3 (β=-0.094, P=0.021) but it did not remain significant after any objective fitness indicator was included in the model. Other objectively measured or self-reported assessments of PA were not significantly associated with inflammatory markers. All objective measures of fitness were inversely associated with CRP, C3 and C4, whereas only self-reported motor fitness remained significantly associated with C3, C4 and TNF-α. All these observations were independent of age, sex, city and body mass index or waist circumference., Conclusion: High PA in adolescence may play an indirect role on lessening low-grade inflammation through improvements in fitness., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

We aimed to examine the associations of sleep duration with time spent on sedentary, moderate and vigorous activities in children and adolescents. The sample consisted of 2,241 (53.5% girls) Estonian and Swedish children (9-10 years) and adolescents (15-16 years), from the European Youth Heart Study, in 1998-1999. Sleep duration was calculated by the difference between self-reported bedtime and time for getting up on a normal weekday. Sedentary time/physical activity was measured by accelerometry (valid data on 1,462 participants). Adolescents had lower odds than children, and Swedish higher odds than Estonian, of meeting the sleep recommendations (>9 h) (OR = 0.22, 95% CI 0.17-0.27; and 1.32, 1.07-1.61, respectively). Participants sleeping longer than 10 h spent more time on physical activities (all intensities) and less time on sedentary activities than those sleeping shorter durations (all P < 0.001). The associations with physical activity became non-significant after additional adjustment for age or sexual maturation (Tanner stages), whereas the associations with sedentary time became borderline significant (P = 0.09/0.03, for age and Tanner, respectively). In conclusion, these results do not suggest a link between sleep durations and activity in a relatively large sample of children and adolescents from two European countries. Consequently, the common assumption that physical activity is a mediator in the relationship between short sleep durations and obesity is not supported by our findings.

Background: Recent epidemiologic evidence points to the health risks of prolonged sitting, that are independent of physical activity, but few papers have reported the descriptive epidemiology of sitting in population studies with adults., Purpose: This paper reports the prevalence of "high sitting time" and its correlates in an international study in 20 countries., Methods: Representative population samples from 20 countries were collected 2002-2004, and a question was asked on usual weekday hours spent sitting. This question was part of the International Prevalence Study, using the International Physical Activity Questionnaire (IPAQ). The sitting measure has acceptable reliability and validity. Daily sitting time was compared among countries, and by age group, gender, educational attainment, and physical activity., Results: Data were available for 49,493 adults aged 18-65 years from 20 countries. The median reported sitting time was 300 minutes/day, with an interquartile range of 180-480 minutes. Countries reporting the lowest amount of sitting included Portugal, Brazil, and Colombia (medians ≤180 min/day), whereas adults in Taiwan, Norway, Hong Kong, Saudi Arabia, and Japan reported the highest sitting times (medians ≥360 min/day). In adjusted analyses, adults aged 40-65 years were significantly less likely to be in the highest quintile for sitting than adults aged 18-39 years (AOR=0.796), and those with postschool education had higher sitting times compared with those with high school or less education (OR=1.349). Physical activity showed an inverse relationship, with those reporting low activity on the IPAQ three times more likely to be in the highest-sitting quintile compared to those reporting high physical activity., Conclusions: Median sitting time varied widely across countries. Assessing sitting time is an important new area for preventive medicine, in addition to assessing physical activity and sedentary behaviors. Population surveys that monitor lifestyle behaviors should add measures of sitting time to physical activity surveillance. Moreover, the use of objective measures to capture the spectrum of sedentary (sitting) and physical activity behaviors is encouraged, particularly in low- and middle-income countries commencing new surveillance activities., (Copyright © 2011 American Journal of Preventive Medicine. All rights reserved.)

The authors' aim in this cross-sectional study was to characterize levels of objectively measured physical activity and sedentary time in adolescents from 9 European countries. The study comprised 2,200 European adolescents (1,184 girls) participating in the HELENA cross-sectional study (2006-2008). Physical activity was measured by accelerometry and was expressed as average intensity (counts/minute) and amount of time (minutes/day) spent engaging in moderate- to vigorous-intensity physical activity (MVPA). Time spent in sedentary behaviors was also objectively measured. Cardiorespiratory fitness was measured by means of the 20-m shuttle run test. Level of maternal education was reported by the adolescents. A higher proportion of boys (56.8% of boys vs. 27.5% of girls) met the physical activity recommendations of at least 60 minutes/day of MVPA. Adolescents spent most of the registered time in sedentary behaviors (9 hours/day, or 71% of the registered time). Both average intensity and MVPA were higher in adolescents with high cardiorespiratory fitness, and sedentary time was lower in the high-fitness group. There were no physical activity or sedentary time differences between maternal education categories. These data provide an objective measure of physical activity and amount of time spent in sedentary behaviors in a relatively large number of European adolescents.

The purpose was to compare data obtained from a modified, long, self-administered version of the International Physical Activity Questionnaire (IPAQ-A) with objective data obtained in parallel from Actigraph accelerometers, and VO(2)max in adolescents. The study comprised a total of 2018 adolescents (46% male) from ten European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Physical activity was assessed over seven consecutive days by accelerometry and expressed as min/day of moderate, vigorous, and moderate to vigorous (MVPA) physical activity (PA). PA was also assessed with the IPAQ-A. VO(2)max was estimated from a 20-m shuttle run test. Poor to fair correlations between the two methodologies were found for the whole study sample and when stratified by age and gender (r(s) = 0.08-0.26, p < 0.01). On average, the self-reported time spent in moderate PA was higher compared to the time measured with the accelerometer, while the differences between both instruments were less clear for vigorous intensity. Adolescents reporting high levels of PA (3rd tertile IPAQ-A) also showed higher levels of PA (accelerometers) in all the study variables (moderate, vigorous and MVPA), compared to adolescents reporting low PA (1st tertile IPAQ-A) (all p < 0.001). Both methods were moderately correlated with estimated VO(2)max. Within the HELENA-study, the IPAQ-A showed the modest comparability with the accelerometer data for assessing PA in each intensity level and was the highest for vigorous intensity. Both instruments are able to detect the adolescents with the highest cardio respiratory fitness, which are the most active adolescents., (Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.)

We assessed commuting patterns in adolescents from 10 European cities and examined associations with physical activity (PA). A total of 3112 adolescents were included. PA was objectively measured with accelerometry. Commuting patterns and overall PA were self-reported using questions from the International Physical Activity Questionnaire modified for adolescents (IPAQ-A). Adolescents reported to spend 30 min (15,60) [expressed as median (25th, 75th percentiles)] walking. In boys, associations between active commuting (walking and biking) and PA levels were observed for moderate, moderate-to-vigorous and overall PA. In girls, these associations were observed for moderate and moderate-to-vigorous PA (walking). Similar results were found with the IPAQ-A. We observed positive associations between overall commuting and PA levels in European adolescents, yet due to the cross-sectional study design we cannot state the direction of these. Future studies should address the causation between active commuting and PA levels.

Background: Evidence suggests possible synergetic effects of multiple lifestyle behaviors on health risks like obesity and other health outcomes. Therefore it is important to investigate associations between dietary and physical activity behavior, the two most important lifestyle behaviors influencing our energy balance and body composition. The objective of the present study is to describe the relationship between energy, nutrient and food intake and the physical activity level among a large group of European adolescents., Methods: The study comprised a total of 2176 adolescents (46.2% male) from ten European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Dietary intake and physical activity were assessed using validated 24-h dietary recalls and self-reported questionnaires respectively. Analyses of covariance (ANCOVA) were used to compare the energy and nutrient intake and the food consumption between groups of adolescents with different physical activity levels (1st to 3rd tertile)., Results: In both sexes no differences were found in energy intake between the levels of physical activity. The most active males showed a higher intake of polysaccharides, protein, water and vitamin C and a lower intake of saccharides compared to less active males. Females with the highest physical activity level consumed more polysaccharides compared to their least active peers. Male and female adolescents with the highest physical activity levels, consumed more fruit and milk products and less cheese compared to the least active adolescents. The most active males showed higher intakes of vegetables and meat, fish, eggs, meat substitutes and vegetarian products compared to the least active ones. The least active males reported the highest consumption of grain products and potatoes. Within the female group, significantly lower intakes of bread and cereal products and spreads were found for those reporting to spend most time in moderate to vigorous physical activity. The consumption of foods from the remaining food groups, did not differ between the physical activity levels in both sexes., Conclusion: It can be concluded that dietary habits diverge between adolescents with different self-reported physical activity levels. For some food groups a difference in intake could be found, which were reflected in differences in some nutrient intakes. It can also be concluded that physically active adolescents are not always inclined to eat healthier diets than their less active peers., (© 2011 Ottevaere et al; licensee BioMed Central Ltd.)

Objectives: This study aims to review systematically the repeatability and validity of questionnaires used to assess occupational physical activity among healthy adults., Methods: We searched PubMed and Embase using occupational, work-related, job-related, physical activity, motor activity, and questionnaires as keywords. Two reviewers independently performed article selection, data extraction, and quality assessment. The methodological quality and results of the studies were evaluated based on an existing checklist. The level of evidence and repeatability, criterion, and construct validity were rated., Results: We included 31 papers describing 30 questionnaires in the review. Repeatability was assessed in 22 studies, 11 used appropriate measures to assess 12 questionnaires. Intra-class correlation coefficients and weighted Cohen's kappa ranged between 0.43-0.95. Six studies used appropriate measures to assess criterion validity of 13 questionnaires. One questionnaire, the Tecumseh Self Administered Occupational Physical Activity Questionnaire (TOQ), showed good criterion validity against a physical activity (PA) record. Eighteen studies used appropriate measures to assess the construct validity of 23 questionnaires. Comparison included those against accelerometers, maximal oxygen uptake, questionnaires, and body composition measures. None showed good construct validity., Conclusions: There is strong evidence for good reliability of four questionnaires. None of the reviewed questionnaires showed good criterion validity compared to objective measures. Compared to PA records, moderate-to-good validity was observed for two questionnaires. Objective measures of occupational PA are needed.

Aims: The purpose was to describe the patterns of commuting to school in young people and to examine its associations with physical activity (PA) and cardiorespiratory fitness., Methods: The sample comprised 2271 Estonian and Swedish children and adolescents (1218 females) aged 9-10 years and 15-16 years. Data were collected in 1998/99. Mode of commuting to and from school was assessed by questionnaire. Time spent (min/day) in PA and average PA (counts/min) was measured by accelerometry. Cardiorespiratory fitness was assessed by means of a maximal cycle ergometer test., Results: Sixty-one percent of the participants reported active commuting to school (ACS). Estonian youth showed lower levels of ACS than Swedish (odds ratio, 0.64; 95% confidence interval, 0.53-0.76) and girls reported lower levels than boys (0.74; 0.62-0.88). ACS boys showed higher PA levels than non-ACS boys for moderate, vigorous, MVPA, and average PA levels (all p ≤ 0.01). Participants who cycled to school had higher cardiorespiratory fitness than walkers or passive travellers (p < 0.001)., Conclusions: Nearly two-thirds of the participants actively commuted to school. ACS may provide an opportunity to increase levels of daily PA, especially in boys, and cardiorespiratory fitness, especially if cycling. Public health strategies should develop and test ACS patterns to get more evidence and promote bike-friendly environments.

Objective: To examine the association of participation in physical sports activity during leisure time, sedentary behaviors, cardiorespiratory and muscular fitness, and weight status with cognitive performance in Spanish adolescents., Study Design: This cross-sectional study comprised a total of 1820 adolescents (958 female) aged 13.0 to 18.5 years. Cognitive performance (verbal, numeric and reasoning abilities, and an overall score) was measured with the "SRA-Test of Educational Ability." Participation in physical sports activity during leisure time (yes/no) and time devoted to study, television viewing, and playing video games were self-reported and categorized as ≤ 3 hours/day and >3 hours/day. We assessed cardiorespiratory and muscular fitness with field-based tests. Adolescents were classified as underweight, normal weight, overweight, and obese., Results: Participation in physical sports activities during leisure time was associated with better cognitive performance study variables (all P < .001), independent of potential confounders including cardiorespiratory fitness and body mass index. We did not observe an association of time devoted to study, television viewing, or playing video-games with cognitive performance. Likewise, cognitive performance was similar across cardiorespiratory and muscular fitness levels and body weight categories., Conclusion: Participation in physical sports activity during leisure time may positively influence cognitive performance in adolescents., (Copyright © 2010 Mosby, Inc. All rights reserved.)

The objective of this study is to analyse the association of objectively assessed physical activity (PA) with muscular strength and fat-free mass in adolescents, and to determine whether meeting the current PA recommendations is associated with higher levels of muscular strength and fat-free mass. The present cross-sectional study comprised 363 Spanish adolescents (180 females) aged 12.5-17.5 years. PA was assessed by accelerometry and expressed as average PA (counts/min), and min/day of inactive, light, moderate, vigorous and moderate to vigorous PA (MVPA). MVPA was dichotomized into < 60 min/day and > or = 60. Upper body muscular strength was measured with the handgrip strength test, and lower body muscular strength was measured with the standing broad jump, squat jump, counter movement jump and Abalakov tests. Fat-free mass was measured by DXA. We observed positive associations between vigorous PA and all the lower body muscular strength tests except for the counter movement jump in males. PA was not associated with fat-free mass in both males and females. Male adolescents engaged in at least 60 min/day MVPA performed better in the standing broad jump test. In conclusion, the findings of the present study suggest that only vigorous PA is associated with muscular strength, particularly lower-body muscular strength in male adolescents.

This study compares levels and patterns of objectively assessed physical activity in Sweden and the United States by using identical accelerometer metrics. Data of adult respondents with > or =4 days with > or =10 hours per day of accelerometer wear from Sweden (2001-2002, n = 1,172) and the United States (2003-2004, n = 2,925) were compared. Outcomes reported by age and body mass index within sex include accelerometer counts per minute and amounts and bouts of activity at different intensities, that is, sedentary, low, lifestyle, and moderate or higher intensity physical activity. The mean counts per minute were 375 (95% confidence interval (CI): 360, 390) and 377 (95% CI: 363, 391) for Swedish and US males, respectively, and 363 (95% CI: 347, 379) and 298 (95% CI: 289, 307) for Swedish and US females. Older respondents and those with higher body mass index had lower activity levels. Swedish and US males spent 36 (95% CI: 34, 38) and 33 (95% CI: 31, 36) minutes per day, and Swedish and US females spent 32 (95% CI: 29, 34) and 19 (95% CI: 17, 21) minutes per day in moderate or higher intensity physical activity. Older Swedes were more active in moderate or higher intensity activities than were older US respondents. However, younger Swedish males had more sedentary behavior time than did younger US males. These results provide a framework for international comparisons of physical activity levels and patterns, and they represent strong evidence for the importance of investment in objective measurement of physical activity.

Physical inactivity and its accompanying adverse sequelae (e.g., obesity and diabetes) are global health concerns. The single most commonly reported physical activity in public health surveys is walking (Centers for Disease Control and Prevention, 2000; Rafferty, Reeves, McGee, & Pivarnik, 2002). As evidence accumulates that walking is important for preventing weight gain (Levine et al., 2008) and reducing the risk of diabetes (Jeon, Lokken, Hu, & van Dam, 2007), there is increased need to capture this behavior in a valid and reliable manner. Although the disadvantages of a self-report methodology are well known (Sallis, & Saelens, 2000), it still represents the most feasible approach for conducting population-level surveillance across developed and developing countries. The International Physical Activity Questionnaire (IPAQ) was created and evaluated as a standardized instrument for this purpose. Although two versions of the IPAQwere designed and evaluated (short: nine items; and long: 31 items), the short form was recommended for population monitoring (Craig et al., 2003). However, it has not been recommended for intervention or research studies that require precise physical activity quantification to examine changes in physical activity at the individual level. IPAQ was also not intended to replace instruments that are more responsive to individual changes in activity level, such as objective measures. In addition to walking behaviors, IPAQ also assesses time spent in moderate- and vigorous-intensity activity as well as sitting behaviors, although the latter is not the focus of this analysis. Aggregated IPAQ data have been previously validated compared to accelerometers, and overall reliability was confirmed across 12 countries (Craig et al., 2003). Previous research showed criterion validity Spearman correlations with a median of 0.30 and test-retest reliability Spearman correlations clustered around 0.8 (Craig et al., 2003). The purpose of this study, however, was to reanalyze these data with respect to validity (again compared to an accelerometer) and test-retest reliability specifically for population monitoring of walking.

Objective: Valid and simple instruments to assess physical activity (PA) in specific populations are required for health-related research. The aim of the present study was to assess the validity of the Bouchard activity diary (AD) in Spanish adolescents using an activity monitor to compare total PA and moderate-to-vigorous PA (MVPA) obtained by both instruments., Design: Sixty-one Spanish adolescents, aged 12-16 years, completed the Bouchard AD and wore the ActiGraph activity monitor for three consecutive days. Validity was assessed with the Spearman correlation coefficient (rho), the Bland-Altman method and the kappa coefficient., Results: Thirty-seven adolescents were included in the final analysis. Correlations between the activity monitor and the AD administered over the three days (Thursday-Saturday) were moderate (rho = 0.33-0.35, P < 0.05) or non-significant for total PA and moderate (rho = 0.36, P < 0.05) for MVPA. Correlations between the two methods were progressively lower for each subsequent day of testing, for both total PA and MVPA. The Bland-Altman plot illustrated that the Bouchard AD overestimated MVPA (mean difference -32.05 (sd 74.56) min; 95 % limits of agreement 109.61, -173.31 min). Agreements for classification into MVPA tertiles and accordance with the international recommendations of MVPA were fair and moderate, respectively, for the 3 d means., Conclusions: The Bouchard AD has reasonable validity to assess total PA and MVPA in Spanish adolescents. The results show lower levels of agreement on the third day but it is not clear if this is due to design features (weekday v. weekend) or to participant compliance with the survey or the activity monitoring protocol.

Objectives: To examine the association of objectively assessed physical activity (PA) with markers of total and central body fat in adolescents, and to determine whether meeting the current PA recommendations (> or = 60 min day(-1) of at least moderate intensity PA) is associated with reduced levels of total and central body fat., Subjects/methods: A total of 365 Spanish adolescents aged 12.5-17.5 years participated in this cross-sectional study. PA was assessed by accelerometry and expressed as average PA (counts per minute), and min day(-1) of light, moderate, moderate to vigorous (MVPA) and vigorous PA. MVPA was dichotomized into < 60 min day(-1) and > or = 60. Total body fat was measured by DXA, BodPod and the sum of six skinfolds. Central body fat was measured by DXA at three regions (R1, R2 and R3), and waist circumference., Results: All markers of central body fat were negatively associated with vigorous PA (P < 0.01) after controlling for sex, age and pubertal status. Abdominal adiposity measured at R1, R2 and R3 was also negatively associated with MVPA (P < or = 0.001), and with average PA (P < 0.01). All markers of total body fat were negatively associated with vigorous PA (P < 0.01), MVPA (P < 0.01) and average PA (P < 0.05). Adolescents engaged on at least 60 min day(-1) MVPA presented lower levels of total (P < 0.05) and central body fat (P < or = 0.01)., Conclusions: The results suggest that vigorous PA may have a greater effect on preventing obesity in adolescents than does PA of lower intensity, whereas both average PA and at least moderate PA may have an impact on total and central body fat in youth.

Introduction and Objectives: Cardiovascular fitness (CVF) has been considered a health marker at all ages. The main purpose of this study was to examine whether meeting the current physical activity (PA) recommendations is associated with a healthier CVF level in adolescents., Methods: A total of 472 adolescents (14-16 years-old) were studied. CVF was estimated from a maximal bike test and PA was objectively assessed by accelerometry. Subjects were classed as high/low-CVF level, according to the Cooper Institute's cut-offs, and having a high/low-PA level depending on if the adolescents were engaged in at least 60 min per day at moderate-vigorous PA intensity level. Body fat was estimated from skinfold thicknesses., Results: Binary logistic regression showed that adolescent girls meeting the current PA recommendations (> or = 60 min/day of moderate-vigorous PA) were three times more likely to have a high-CVF level than girls that did not meet the recommendations, after controlling for sexual maturation status (Tanner stages) and body fat. Likewise, adolescent boys meeting the PA recommendations were eight times more likely to have a high-CVF level than boys that did not meet the recommendations., Conclusions: The results suggest that devoting 60 min or more to moderate-vigorous PA daily is associated with a healthier CVF level in adolescents, independent of maturation status and adiposity. The patterns of the association were similar in girls and boys, but the fact that the associations were weaker in girls is of concern.

The aim of this study was to assess profiles of physical activity (PA) behavior using accelerometers among middle-aged and elderly women in free-living conditions. A subset of 133 women aged 56-75 years from the population-based Swedish Mammography Cohort with valid accelerometer data was included in the analysis. The proportion of women who met the PA recommendation of accumulating 30 min of moderate-to-vigorous physical activity (MVPA), in either one continuous bout or several shorter bouts lasting 8-10 min, on five or more days/week was 31%. The precision of mean daily estimates of MVPA and of inactivity based on 7 days monitoring was 0.80 and 0.86, respectively. On average, participants spent 103 min/day on MVPA, but only about a third of that time was accumulated in the recommended pattern of bouts lasting at least 8-10 min. Obese women had, on average, one bout of MVPA less than normal-weight women (mean 3.6 bouts/day). The mean MVPA decreased 10 min/day with every 5-year increase in age. A low proportion of women accumulated MVPA in the pattern recommended for health benefits. The proportion would increase considerably if women maintained their current amount of MVPA but increased the duration of each bout of MVPA.

Objective: To examine the associations of low-grade inflammation with objectively measured physical activity, cardiovascular fitness (CVF) and fatness in prepubertal children., Design: Cross-sectional study., Subjects: One hundred and forty-two children (74 boys and 68 girls) aged 9-10 years (pubertal stage I and II) from the Swedish part of the European Youth Heart Study., Measurements: Total physical activity and its intensity levels (moderate, vigorous, moderate + vigorous) were measured by accelerometry. CVF was measured with a maximal ergometer bike test. Body fat was derived from the sum of five skinfold thicknesses. The measured low-grade inflammatory markers include C-reactive protein, fibrinogen, complement factors C3 and C4., Results: C-reactive protein and C3 were negatively associated with CVF (beta=-0.254 and -0.267, respectively, P<0.05) and positively associated with body fat (beta=0.439 and 0.446, respectively, P<0.001), after controlling for sex, age and pubertal development. C-reactive protein and C3 were not significantly associated with CVF once body fat was in the model. Low-grade inflammation was not associated with physical activity, but physical activity was associated with CVF., Conclusions: The results showed that low-grade inflammatory markers were negatively associated with CVF and positively associated with body fat in prepubertal children. For most of the variables, the influence of fatness was slightly higher than the influence of CVF. The findings suggest that the potential beneficial effects of physical activity on low-grade inflammation may be explained by its association with CVF. Understanding the interplay between physical activity, CVF and fatness may be of importance to reducing cardiovascular disease risk in young people.

Introduction: Strong evidence suggests a link between physical inactivity and chronic disease prevalence in the adult population. To target the right groups for interventions in a population, accurate assessment of physical activity is important. The objective of this study was to assess the levels and pattern of physical activity and inactivity in an adult population sample using an objective method., Methods: In total, 1114 adults (56% women, 45+/-15 yr), randomly recruited from the Swedish population across a year, used an accelerometer (Actigraph MTI) for seven consecutive days. Inactivity was defined as <100 counts per minute, and cutoff values for moderate and vigorous activity were 1952-5724 and >5724 counts per minute, respectively. Average intensity was measured as counts per minute., Results: The adults were active in at least moderate-intensity activity for a median (intraquartile range) of 31 (18-47) min.d(-1). Fifty-two percent accumulated 30 min.d(-1) of at least moderate-intensity physical activity. Only 1% achieved those 30 min from three or more bouts of at least 10 min. Average intensity, moderate and vigorous physical activity was lower with higher age or body mass index (BMI). Men spent more time than women in moderate and vigorous physical activity, but there was no gender difference in average intensity. The variation in inactivity could not be explained by gender, age, or BMI., Conclusion: Objectively obtained estimates of physical activity yielded lower values and a different activity pattern compared with those obtained by commonly used self-reports. This highlights the need to better understand the nature and measurement issues of health-enhancing physical activity of adults.

Background: Physical activity and cardiorespiratory fitness are closely related to health variables in adults, especially those considered to be among risk factors for cardiovascular diseases. The possible tracking of cardiovascular disease risk factors from childhood to adulthood makes it important to increase our understanding of the complex relationships between physical activity, cardiorespiratory fitness and cardiovascular risk factors early in life., Design: A cross-sectional, school-based study on healthy children and adolescents, aged 9-10 years (295 girls, 295 boys) and 15-16 years (302 girls, 233 boys) was performed during a school year in Sweden and Estonia, as part of the European Youth Heart Study., Methods: Total physical activity, and minutes spent in inactivity and activity of moderate or higher intensity were measured by accelerometry. A maximal ergometer bike test was used for estimation of cardiorespiratory fitness. The risk factors included blood pressure and fasting blood levels of insulin, glucose, triglycerides, total cholesterol and high-density lipoprotein cholesterol., Results: Canonical correlations between physical activity and cardiorespiratory fitness versus cardiovascular disease risk factors showed significant associations in both age and sex groups (rc=0.46-0.61, P<0.0001). The cardiorespiratory fitness was found to be the strongest contributor to these relationships. In girls high values of the physical activity variables were also associated with a favourable cardiovascular profile., Conclusions: Cardiorespiratory fitness relates more strongly to cardiovascular risk factors than components of objectively measured physical activity in children and adolescents. Physical activity becomes more important in the 15-year-old adolescents, indicating that these modifiable lifestyle factors increase in importance with age.

Objectives: To examine the associations of physical activity (PA) at different levels and intensities and cardiorespiratory fitness (CRF) with a clustering of metabolic risk factors in children and adolescents with special consideration of body fat., Study Design: Total PA and intensity levels were measured by accelerometry in children (9 years, n = 273) and adolescents (15 years, n = 256). CRF was measured with a maximal ergometer bike test. Measured outcomes included fasting insulin, glucose, triglycerides, total and high-density lipoprotein cholesterol, blood pressure, and body fat. A metabolic risk score (MRS) was computed as the mean of the standardized outcome scores. A "non-obesity-MRS" was computed omitting body fat from the MRS. Analysis of variance and multiple regressions were used in the analysis., Results: Total and vigorous PA was inversely significantly associated with MRS in adolescent girls, the group with lowest PA, becoming insignificant when CRF was introduced in the analysis. Significant regression coefficients of total PA and CRF on non-obesity-MRS diminished when body fat was entered in the analysis., Conclusions: CRF is more strongly correlated to metabolic risk than total PA, whereas body fat appears to have a pivotal role in the association of CRF with metabolic risk.

Background: Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity., Methods: Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity., Results: Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode., Conclusions: The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.