Culturally tailored aerobic exercise intervention for low-income Latinas

PURPOSE: To determine the efficacy of community-based, culturally tailored exercise intervention on the moderate and vigorous physical activity and physiologic outcomes of low-income Latino women (Latinas). DESIGN: A randomized trial contrasted safety education to an aerobic dance intervention. SETTING: Interventions were held in a "store-front" exercise site near a community clinic. SUBJECTS: Sedentary low-income Latinas (N = 151; 18-55 years; 70% overweight/obese) were recruited. Retention was 91% for follow-up measures. INTERVENTION: Three sessions per week of supervised aerobic dance were provided for 6 months. Controls attended 18 safety education sessions over 6 months. MEASURES: Physical activity and aerobic fitness (VO2max) were primary outcomes. RESULTS: Participants in the exercise group reported more vigorous exercise (p < .001) and walking (p = .005) at post-test than controls. Aerobic dance and unsupervised activity resulted in a five-fold greater increase in relative VO2max compared with controls (p < .001). Although exercise and fitness decreased at follow-up, vigorous exercise (p = .001) and relative VO2max (p < .001) remained higher in the exercise group, suggesting maintenance at 1 year. CONDUSION:. Culturally tailored aerobic dance can increase vigorous physical activity, possibly generalizing to walking, and the combination can improve cardiorespiratory fitness in low-income, overweight, sedentary Latinas.     

Exercise training and nutrient intake in elderly women

This study examined the relationship between moderate exercise training (five 30- to 40-minute sessions per week for 12 weeks at 60% of heart rate reserve) and changes in nutrient intake in a group of 30 sedentary elderly women aged 67 to 85 years. Subjects were placed randomly into two groups (those who walked and those who did calisthenics) and were followed for 12 weeks. Measurements were done at three times (baseline, 5 weeks, and 12 weeks). Dietary intake was based on 7-day food records. The 12-week walking program resulted in a significant (12.6%) improvement in maximum oxygen consumption ( ₂max) but no change in body weight or skinfold thicknesses compared with the calisthenics program. Despite the improvement in cardiorespiratory fitness, no significant group × time interaction effects were observed for most of the nutrient intake variables tested. To test the effects of high levels of physical activity on nutrient intake, cross-sectional comparisons were made at baseline between highly conditioned and sedentary elderly women. The highly conditioned elderly women had higher energy and nutrient intakes, especially when expressed on a weight-adjusted basis. However, no differences in measures of dietary quality were found. Dietitians should not expect spontaneous improvement in either the quantity or quality of nutrient intake by elderly women who adopt a moderate exercise program. Although nutrient intake was greater in highly conditioned elderly women, their level of fitness and physical activity may be beyond the reach of many elderly women.     

Glucose intolerance and physical inactivity: the relative importance of low habitual energy expenditure and cardiorespiratory fitness

Glucose intolerance and diabetes mellitus are associated with physical inactivity, but it is unclear whether preventive interventions should aim at increasing overall energy expenditure or increasing participation in vigorous, fitness-enhancing activities. Studies aimed at separating and quantifying the effects of these two dimensions of physical activity should use well-validated measurement instruments and employ a study design in which the bivariate error structure of these instruments is determined. In the Isle of Ely Study (Cambridgeshire, United Kingdom), 775 individuals aged 45-70 years in 1994-1997 completed a glucose tolerance test and assessment of 4-day physical activity level (total energy expenditure/basal metabolic rate) by heart rate monitoring, a technique that has been validated against doubly labeled water and whole-body calorimetry. Cardiorespiratory fitness (maximum oxygen uptake (VO2max) per kg)) was measured in a submaximal test. To correct for measurement error, the authors had 190 individuals repeat both tests on three occasions at 4-month intervals. Two-hour glucose level was negatively correlated with physical activity level (men: r = -0.22, p < 0.001; women: r = -0.11, p < 0.05) and VO2max per kg (men: r = -0.18, p < 0.01; women: r = -0.19, p < 0.001) and was positively correlated with age and obesity. The model incorporating bivariate adjustment for measurement error showed that energy expenditure had a major effect on glucose tolerance, but there was less of an effect for cardiorespiratory fitness. These data provide support for public health strategies aimed at increasing overall energy expenditure.     

Speed and exercise intensity of recreational walkers

BACKGROUND: Brisk walking has been identified as an activity suited to meet American College of Sport Medicine/Centers for Disease Control and Prevention recommendations for moderate intensity exercise (55-69% HR(max), 40-59% VO(2)R). However, little is known about whether recreational walkers self-select a pace which elicits this intensity and how they interpret the term "brisk walking." METHODS: The walking speed of 82 adults was covertly observed in a public park. Fifty-nine of these participants demonstrated their interpretation of "brisk walking" and the speed was noted. Eleven of these subjects subsequently walked on a treadmill at their observed and "brisk walk" speeds. Heart rate (HR), respiratory gases, and ratings of perceived exertion (RPE) were measured. RESULTS: Mean observed and "brisk" walking speeds were 1.56 +/- 0.17 m. s(-1) and 1.79 +/- 0.19 m x s(-1) respectively (P < or = 0.001). Mean exercise intensities during the treadmill test (n = 11) were 59.0 +/- 13.4% VO(2max) and 67.3 +/- 11.6% HR(max) for the observed speed (1.60 + 0.24 m x s(-1)). The brisk speed (1.86 +/- 0.12 m x s(-1)) equated to 68.6 +/- 14.9% VO(2max) and 78.5 +/- 15.5% HR(max). CONCLUSION: The speed and intensity selected by this group of walkers meets current recommendations for moderate intensity exercise. Instructing individuals to "walk briskly" prompts more vigorous activity.     

Work ability, physical activity, and cardiorespiratory fitness: 2-year results from Project Active

An adequate level of physical activity may maintain or promote work ability in aging workers. Project Active is a randomized trial comparing a Lifestyle physical activity program with a Structured exercise program in sedentary but healthy adults aged 35 to 60 years. Subjects in both groups received 6 months of intensive intervention followed by 18 months of active follow-up. The total number of subjects was 235, from which 80 subjects participated in the work ability assessment. Primary outcome measures were energy expenditure (kcal.kg-1.day-1), cardiorespiratory fitness (peak oxygen uptake in ml.min-1.kg-1), and the Work Ability Index. At 6 months, daily energy expenditure had increased significantly over baseline (mean +/- SD, from 33.0 +/- 0.9 to 34.4 +/- 1.8 kcal.kg-1.day-1) and was maintained over baseline at 24 months (34.0 +/- 2.5 kcal.kg-1.day-1). The significant increase in energy expenditure was observed particularly in moderate levels of activity. The average percentage of body fat was significantly higher at baseline compared with 6 months and 24 months. Peak oxygen uptake increased from baseline significantly during the first 6 months (from 29.6 +/- 5.7 to 30.6 +/- 6.3 ml.min-1.kg-1) and decreased to the baseline level (29.1 +/- 5.5 ml.min-1.kg-1) at 24 months. At baseline, the average Work Ability Index was 44.2 +/- 4.0, and it remained unchanged at 6 months (44.4 +/- 3.9) and at 24 months (44.2 +/- 3.1). In conclusion, a 2-year physical activity intervention increased daily energy expenditure, reduced body fat, and maintained peak oxygen uptake in healthy, middle-aged, sedentary subjects. The average Work Ability Index score at baseline was excellent and did not change during the 2-year physical activity interventions.     

Comparison of perceived health to physiological measures of health in Black and White women

BACKGROUND: Obesity and sedentary lifestyles are prevalent among minority women. This study compared perceived and physiological measures of health in 35 non-Hispanic Black (NHB) and 155 non-Hispanic White (NHW) sedentary women. METHODS: Self-perception of body weight, physical shape and appearance, physical fitness, and eating habits were assessed via questionnaire using 10-point scales (1 = poor, 10 = excellent), and height, weight, aerobic capacity (V(O(2))(max)), and 4-day food records were directly measured. RESULTS: Although body mass index (BMI, 30.3 +/- 5.3 vs 27.2 +/- 4.5 kg/m(2)) and weight (82.7 +/- 16.5 vs 73.1 +/- 12.9 kg) were greater (both P = 0.0001) in NHB, groups were similar in self-perception of physical shape and appearance and weight. V(O(2))(max) was lower in NHB compared to NHW (20.7 +/- 4.5 vs 23.5 +/- 4.6 ml x kg(-1) x min(-1), P = 0.002), despite no difference between groups in self-perception of physical fitness. Finally, there was no difference between groups for self-perception of eating habits and percentage of calories derived from fat (%fat). The results were unchanged after adjusting for age, education, and income, except that %fat was greater in NHB compared to NHW (35.7 +/- 6.3 vs 33.8 +/- 6.9%, P = 0.03). CONCLUSIONS: Although NHB were heavier, more obese, less fit, and consumed a greater %fat than NHW, they perceived their weight, physical shape and appearance, physical fitness, and eating habits to be no worse than those of their White counterparts. The perceptions of NHB regarding their weight, fitness, and eating habits may represent barriers to change.     

Physical activity patterns associated with cardiorespiratory fitness and reduced mortality: the Aerobics Center Longitudinal Study.

OBJECTIVES: This study examined cross sectionally the physical activity patterns associated with low, moderate, and high levels of cardiorespiratory fitness. METHODS: Physical activity was assessed by questionnaire in a clinic population of 13,444 men and 3972 women 20 to 87 years of age. Estimated energy expenditure (kcal.wk-1) and volume (min.wk-1) of reported activities were calculated among individuals at low, moderate, and high fitness levels (assessed by maximal exercise tests). RESULTS: Average leisure time energy expenditures of 525 to 1650 kcal.wk-1 for men and 420 to 1260 kcal.wk-1 for women were associated with moderate to high levels of fitness. These levels of energy expenditure can be achieved with a brisk walk of approximately 30 minutes on most days of the week. In fact, men in the moderate and high fitness categories walked between 130 and 138 min.wk-1, and women in these categories walked between 148 and 167 min.wk-1. CONCLUSIONS: Most individuals should be able to achieve these physical activity goals and thus attain a cardiorespiratory fitness level sufficient to result in substantial health benefits.     

Lactation performance of exercising women

To determine whether vigorous exercise affects lactation performance, we compared well-nourished exercising (n = 8) and sedentary (n = 8) women whose infants were 9-24 wk old and exclusively breast-fed. Measurements included resting metabolic rate (RMR); maximum oxygen consumption (VO2max); plasma prolactin, cortisol, insulin, and T3; and body composition. Each subject completed a 3-d record of dietary intake, physical activity, and milk volume (by test weighing) and collected 24-h milk samples. Exercising women differed significantly from control subjects in VO2max (46.4 vs 30.3 mL.kg-1.min-1), percent body fat (21.7 vs 27.9%), total energy expenditure (3169 vs 2398 kcal/d), and energy intake (2739 vs 2051 kcal/d). There was no difference between the groups in plasma hormones or milk energy, lipid, protein, or lactose content. Exercising subjects tended to have higher milk volume (839 vs 776 g/d) and energy output in milk (538 vs 494 kcal/d). Thus, there was no apparent adverse effect of vigorous exercise on lactation performance.     

Free living energy expenditure in post menopausal women before and after exercise training

The aim of the study was to determine the effects of 8 weeks of moderate exercise training, on 24-hour free living energy expenditure in previously sedentary post-menopausal women. The experimental group (EX) included 9 women. Ten non-exercising control subjects (CON) were recruited to undergo pre- and post-testing. Estimated total daily energy expenditure (TDEE), total 24-hour heart beats (HB), total energy intake (TEI), resting metabolic rate, maximal oxygen consumption (VáO2max), body composition, and submaximal heart rate were measured before and after the exercise intervention. Body composition did not change (body fat % in CON 34.0 +/- 4.0% vs. 33.9 +/- 3.6% and EX 34.1 +/- 4.0% vs. 34.0 +/- 3.4%). Mean submaximal heart rate during steady-state exercise in EX was lower after training compared to CON (p < .05); however, VáO2max did not increase significantly (CON 1.96 +/- 0.23 vs. 1.99 +/- 0.24 l L O2/min and EX 1.86 +/- 0.39 vs. 1.94 +/- 0.30 L O2/min). Neither estimated TDEE (CON, 11.6 +/- 2.0 vs. 11.4 +/- 2.78 MJ; and EX 11.4 +/- 3.3 vs. 11.5 +/- 2.5 MJ, pre vs. post, respectively), RMR (CON 134.2 +/- 9.4 vs. 136.9 +/- 15.0 KJ/kgFFM/day, and EX 138.4 +/- 6.4 vs. 140.7 +/- 14.2 KJ/kgFFM/day, pre vs. post, respectively), TEI (CON 7.9 +/- 2.2 vs. 8.2 +/- 2.5 MJ, and EX 9.4 +/-1.6 vs. 8.3 +/- 2.8 MJ), nor HB (CON 110,808 +/- 12,574 vs. 107,366 +/- 12,864 beats, and EX 110,188 +/- 9,219 vs. 114,590 +/- 12,750 beats) change over 8 weeks in either group. These data suggest that a moderate exercise program may not impact on TDEE, RMR, TEI, or HB in previously sedentary, older women.     

Controlled comparison of retention and adherence in home- vs center-initiated exercise interventions in women ages 40-65 years: The S.W.E.A.T. Study (Sedentary Women Exercise Adherence Trial)

BACKGROUND: In an 18-month exercise intervention in previously sedentary older women (40-65 years), we examined whether an initial 6 months of supervised exercise leads to greater long-term retention and adherence to regular physical activity than an unsupervised home-based program and whether these outcomes are influenced by the exercise intensity. METHODS: Women (N = 126) were recruited from the community and randomly assigned to either center-based or home-based exercise three times/week. The center-based group attended supervised sessions for 6 months, while after 10 initial sessions the home-based group exercised at home. After 6 months both groups were home-based for a further 12 months. Within each arm, subjects were further randomized to exercise at either moderate or vigorous intensity. RESULTS: The center-based group had higher retention than the home-based (97, 94, 81 versus 87, 76, and 61%) at 6, 12, and 18 months, respectively (P < 0.05). At 6 months, adherence was higher in the center-based group (84 versus 63%, P < 0.001) and energy expenditure was higher at 6 (P < 0.05) and 12 (P < 0.01) months. At 18 months, retention was higher with moderate exercise (P < 0.05), while adherence was similar with both intensities. CONCLUSION: An initial 6 months of center-based exercise enhanced retention in both the short and the long term and promoted short-term adherence and energy expenditure. Long-term, moderate exercise retained more subjects, but had little influence on adherence.     

Using self-efficacy and a transtheoretical model to develop a physical activity intervention for obese women

PURPOSE: To assess the effectiveness of applying behavior change theory to a physical activity intervention for obese, sedentary women. DESIGN: A 48-week randomized controlled trial. Subjects were randomized to one of two intervention groups. SETTING: A university classroom and a local health club. SUBJECTS: Fifty-eight sedentary, obese women. INTERVENTIONS: A 24-week theory-based physical activity program that aims to change the way subjects think and behave in relation to physical activity (treatment group, n = 29) and a traditionally structured exercise program (control group, n = 29). MEASURES: Questionnaires on physical activity, stage of change, processes of change, and self-efficacy were completed at baseline, 24 weeks, and 48 weeks. RESULTS: Twenty-seven of the 29 participants in the treatment group and 17 participants in the control group completed the study. Analysis of variance revealed significant and positive changes in measures of eight processes of change, self-efficacy, physical activity, and cardiorespiratory fitness in the treatment group at 24 weeks. All but one of these changes were maintained at 48 weeks. In the control group, significant changes occurred in only two processes of change, and no change occurred in self-efficacy, physical activity, or cardiorespiratory fitness at 24 or 48 weeks. CONCLUSION: A theory-based intervention is more likely to change the way obese women think and behave in relation to physical activity than a traditional exercise program that does not incorporate behavior change theory.     

Worksite intervention effects on physical health: a randomized controlled trial

Overweight and physical inactivity are risk factors for increased disease burden and health care expenditure. Well-designed studies are still needed to determine the treatment efficacy of worksite interventions targeting such risk factors. This randomized controlled trial was conducted at one of Australia's casinos in 2002-2003, to investigate the effects of a comprehensive exercise and lifestyle intervention on physical fitness. Only 6.4% of the workforce expressed interest in being study participants. Seventy-three employees (aged 32 +/- 8 years, 51% overweight/obese, 73% shift workers and 52% women) were recruited and randomized to treatment or wait-list control groups for 24 weeks, 44 of whom completed the intervention. Components of the intervention include supervised moderate-to-high intensity exercise including combined aerobic (at least 20 min duration 3 days/week) and weight-training (for an estimated 30 min completed 2-3 days/week), and dietary/health education (delivered via group seminars, one-on-one counselling and literature through the provision of a worksite manual). ANCOVA, by intention-to-treat and of study completers, found significant between-group differences in the mean waist circumference and predicted maximal oxygen uptake (VO2max), favouring the intervention, but effects were concentrated in one subject. For study completers, between-group differences in the mean waist circumference (82.3 +/- 9.2 versus 90.5 +/- 17.8 cm, p = 0.01) and predicted VO2max (47 versus 41 ml/kg/min, p < 0.001) remained significant without the outlier, favouring the intervention. Higher intervention compliance predicted greater improvements in physical fitness. No significant effects on body mass or body mass index were found. This worksite intervention significantly improved waist circumference and aerobic fitness in healthy but sedentary employees, most of whom were shift workers. Worksite interventions have the potential to counter the increasing burden of overweight and obesity, particularly visceral adiposity, as well as physical inactivity; however, substantial barriers to adoption/adherence need to be overcome for greater feasibility and impact on employee physical health.     

The role of exercise physical activity in varying the total energy expenditure in healthy Japanese men 30 to 69 years of age

This study was designed to examine 1) the role of exercise physical activity (EPA), and then 2) physical fitness and body composition upon variation of the total energy expenditure (TEE) in healthy Japanese men aged 30 to 69 y (n = 40). EPA and TEE were assessed over 14 d using an accelerometer and a doubly labeled water (DLW) method, respectively. Basal metabolic rate (BMR) was measured after 10 h fasting on the morning of the day of DLW dosing. Physical activity-induced energy expenditure (PAEE) was calculated by subtracting BMR and diet-induced thermogenesis (DIT = 101 TEE) from TEE. EPA was subdivided into three intensities: low, moderate and high and the accumulated duration (time expressed in minutes) of each of these was calculated. Body composition and physical fitness (VO2max) were determined using an underwater weighing method and a treadmill exercise test, respectively. BMR (mean +/- SD: 1,459 +/- 181 kcal/d) declined significantly with age (r = -0.37. p < 0.05), but PAEE (946 +/- 320 kcal/d) and TEE (2,672 +/- 369 kcal/d) did not. A multiple stepwise regression analysis was used to develop an empirical model that relates energy expenditure measured by the DLW (TEE) to age, height, body mass index, FM, FFM, percentage body fat, VO2max, and accumulated duration spent for low-, moderate-, and high-intensity EPA. The results revealed that FFM and high-intensity EPA were identified as important determinants of TEE and accounted for 51%. We may therefore conclude that 1) high-intensity EPA appears to be relevant in determining TEE, especially among active individuals, and 2) body composition was more important than physical fitness in determining TEE in this population.     

国际体力活动问卷中文版的信度和效度研究

目的 评价国际体力活动问卷(IPAQ)中文版的信度和效度,提供体力活动水平测量工具。方法 系统抽样94名大学生,间隔3天重复调查检验信度;在39名自愿受试者中,用体力活动(PA)记录和Caltrac加速度计为参照标准检验效度。结果 长短卷各项体力活动组内相关系数均在0.7以上。长卷的体力活动能量消耗与PA记录接近。短卷一日总能量消耗低于PA记录和Cltrac监测值。两个问卷与PA记录的目标体力活动量达标一致率均在70％以上。长卷、短卷和PA记录的每天静坐时间差异无显著性。结论 IPAQ中文版在大学生中的重测信度和效度高于或等于同类问卷。长短卷检测体力活动量达标率与PA记录接近,短卷低估体力活动能量消耗。     

The effects of moderate exercise training on nutrient intake in mildly obese women

The relationship between moderate exercise training (five 45-minute sessions per week, brisk walking at 62 +/- 2% VO2 max for 15 weeks) and changes in nutrient intake was investigated in a group of 36 sedentary, mildly obese women. The study was conducted using a 2 x 3 factorial design (two groups of subjects: exercise and nonexercise groups; three periods: baseline, 6-week, and 15-week testing sessions). Data were analyzed using repeated measures ANOVA. The pattern of change in caloric intake over time tended to be different between groups (F[2, 68] = 2.50, p = .089); the exercise group experienced a significant decrease in caloric intake by 15 weeks. Significant group x time interactions were found for intakes of carbohydrate, dietary fiber, thiamin, niacin, vitamin B-6, and folate. Intake tended to decrease in the exercise group and to increase in the nonexercise group. Change in intake of each of these nutrients was significantly correlated with change in bread and cereal consumption. The pattern of change in bread and cereal intake over time was significantly different between groups (Pillais Trace = 0.266, F[2, 33] = 5.99, p = .006); the exercise group had significant decreases in intake at 6 and 15 weeks vs baseline values. These data suggest that mildly obese women reduce energy intake subsequent to initiating an exercise program; concomitantly there is a decrease in the quality of nutrient intake from their diets compared with those of sedentary controls.     

Characteristics of inactive primary care patients: baseline data from the activity counseling trial. For the Activity Counseling Trial Research Group

BACKGROUND: Although many primary care patients are inactive, being able to classify even small amounts and intensities of activity and factors associated with these activity levels could be helpful for physicians who are trying to motivate their patients to become more physically active. METHODS: Sociodemographics, physical activity, fitness, other cardiovascular risk factors, and psychosocial measures were measured at baseline in the 874 patients in the Activity Counseling Trial. Patients were categorized into three groups: (1) no moderate-to-vigorous physical activity (MVPA), (2) some moderate but no vigorous activity, and (3) some vigorous activity. Multiple logistic regression was used to determine factors cross-sectionally associated with activity intensity. RESULTS: One or more cardiovascular risk factors in addition to physical inactivity were present in 84% of participants. Maximal oxygen uptake averaged 25.2 ml/kg/min; 85% had poor to fair aerobic fitness. Physical activity averaged 32.7 kcal/kg/day, with 13.5 min of MVPA/day; 26% engaged in some vigorous activity, 11% engaged in no MVPA. In unadjusted analyses, gender, age, race, education, income, employment, smoking, alcohol use, and exercise self-efficacy were associated with activity intensity (P = 0.05-0.001). A greater percentage engaged in moderate than in vigorous activity in all subgroups. In multiple logistic regression analyses, odds ratios (95% confidence intervals) for engaging in vigorous activity were 0. 39 (0.28, 0.56) for women, 0.38 (0.19, 0.75) for 65+ compared with 35- to 44-year-olds, and 1.14 (1.06, 1.22) for 10-unit increases in performance self-efficacy score. CONCLUSIONS: Most primary care patients who are physically inactive have additional cardiovascular risk factors, particularly overweight and obesity. All subgroups pursue moderate-intensity activity more often than vigorous activity. Women, older persons, and those with lower exercise self-efficacy are less likely to engage in vigorous activity.     

Validation and calibration of physical activity monitors in children

OBJECTIVE: This study was designed to validate accelerometer-based activity monitors against energy expenditure (EE) in children; to compare monitor placement sites; to field-test the monitors; and to establish sedentary, light, moderate, and vigorous threshold counts. RESEARCH METHODS AND PROCEDURES: Computer Science and Applications Actigraph (CSA) and Mini-Mitter Actiwatch (MM) monitors, on the hip or lower leg, were validated and calibrated against 6-hour EE measurements by room respiration calorimetry, activity by microwave detector, and heart rate by telemetry in 26 children, 6 to 16 years old. During the 6 hours, the children performed structured activities, including resting metabolic rate (RMR), Nintendo, arts and crafts, aerobic warm-up, Tae Bo, treadmill walking and running, and games. Activity energy expenditure (AEE) computed as EE - RMR was regressed against counts to derive threshold counts. RESULTS: The mean correlations between EE or AEE and counts were slightly higher for MM-hip (r = 0.78 +/- 0.06) and MM-leg (r = 0.80 +/- 0.05) than CSA-hip (r = 0.66 +/- 0.08) and CSA-leg (r = 0.73 +/- 0.07). CSA and MM performed similarly on the hip (inter-instrument r = 0.88) and on the lower leg (inter-instrument r = 0.89). Threshold counts for the CSA-hip were <800, <3200, <8200, and > or = 8200 for sedentary, light, moderate, and vigorous categories, respectively. For the MM-hip, the threshold counts were <100, <900, <2200, and > or = 2200, respectively. DISCUSSION: The validation of the CSA and MM monitors against AEE and their calibration for sedentary, light, moderate, and vigorous thresholds certify these monitors as valid, useful devices for the assessment of physical activity in children.     

Physical Activity Pattern and Energy Expenditure of Malaysian Adults: Findings from the Malaysian Adult Nutrition Survey (MANS)

This paper aims to report the physical activity pattern and energy expenditure of adults aged 18 - 59 years in the Malaysian Adults Nutrition Survey (MANS) carried out between October 2002 and December 2003. The survey included 7349 adults representative of Peninsular Malaysia (Northern, Southern, Central and East Coast), as well as Sabah and Sarawak. A total of 6926 adults, comprising 3343 men and 3583 women, completed the physical activity section of the survey. Physical activity data was obtained using a physical activity questionnaire and 24-hour physical activity recall. Basal metabolic rate (BMR) was calculated from Ismail et al. (1998) predictive equations; total energy expenditure (TEE) was then estimated through factorial calculations based on time allocated and energy cost of various activities. Physical activity level (PAL) was calculated as the ratio of TEE to BMR. It was found that almost three-quarters of Malaysian adults traveled by passive modes of transportation. Only a third reported having ever-exercised, and an even smaller proportion of the population (14%) had adequate exercise. The population also spent the majority of their time (74% of the day) in sedentary activities, such as sleeping or lying down; doing light intensity activities (15% of the day), and doing moderate to vigorous intensity activities (10% of the day). Mean BMR and TEE was significantly higher amongst men than women, while mean PAL values were similar for men [1.6 (1.6 - 1.7)] and women [1.6 (1.6 - 1.6)]. More men (16%) were categorised as having active PAL compared to women (10%), while more women (43%) were categorised as having sedentary PAL compared to their male counterparts (37%). The present study provides the first in-depth report of the physical activity pattern, and national estimates of energy expenditure and physical activity levels of Malaysian adults, and concluded that Malaysian adults are generally sedentary. It is thus important that physical activity be further promoted and integrated into the lives of the population, preferably through various health promotion efforts as well as through the commitment of the authorities in providing a suitable environment for an active lifestyle.