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      Socio-economic determinants of physical activity across the life course: A "DEterminants of DIet and Physical ACtivity" (DEDIPAC) umbrella literature review

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      1 , 2 , * , 2 , 3 , 3 , 4 , 5 , 6 , 7 , 8 , 3 , 9 , 5 , 10 , 6 , 6 , 11 , 12 , 13 , 2 , 11 , 14 , 15 , 7 , 16 , 11 , 17 , 17 , 9 , 14 , 8 , 10 , 16 , 17 , 7 , 14 , 12 , 7 , 9 , 3
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          Abstract

          Background

          To date, the scientific literature on socioeconomic correlates and determinants of physical activity behaviours has been dispersed throughout a number of systematic reviews, often focusing on one factor (e.g. education or parental income) in one specific age group (e.g. pre-school children or adults). The aim of this umbrella review is to provide a comprehensive and systematic overview of the scientific literature from previously conducted research by summarising and synthesising the importance and strength of the evidence related to socioeconomic correlates and determinants of PA behaviours across the life course.

          Methods

          Medline, Embase, ISI Web of Science, Scopus and SPORTDiscus were searched for systematic literature reviews and meta-analyses of observational studies investigating the association between socioeconomic determinants of PA and PA itself (from January 2004 to September 2017). Data extraction evaluated the importance of determinants, strength of evidence, and methodological quality of the selected papers. The full protocol is available from PROSPERO (PROSPERO2014:CRD42015010616).

          Results

          Nineteen reviews were included. Moderate methodological quality emerged. For adults, convincing evidence supports a relationship between PA and socioeconomic status (SES), especially in relation to leisure time (positive relationship) and occupational PA (negative relationship). Conversely, no association between PA and SES or parental SES was found for pre-school, school-aged children and adolescents.

          Conclusions

          Available evidence on the socioeconomic determinants of PA behaviour across the life course is probable (shows fairly consistent associations) at best. While some evidence is available for adults, less was available for youth. This is mainly due to a limited quantity of primary studies, weak research designs and lack of accuracy in the PA and SES assessment methods employed. Further PA domain specific studies using longitudinal design and clear measures of SES and PA assessment are required.

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          Most cited references19

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          Health benefits of physical activity: the evidence.

          The primary purpose of this narrative review was to evaluate the current literature and to provide further insight into the role physical inactivity plays in the development of chronic disease and premature death. We confirm that there is irrefutable evidence of the effectiveness of regular physical activity in the primary and secondary prevention of several chronic diseases (e.g., cardiovascular disease, diabetes, cancer, hypertension, obesity, depression and osteoporosis) and premature death. We also reveal that the current Health Canada physical activity guidelines are sufficient to elicit health benefits, especially in previously sedentary people. There appears to be a linear relation between physical activity and health status, such that a further increase in physical activity and fitness will lead to additional improvements in health status.
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            Tracking of Physical Activity from Childhood to Adulthood: A Review

            The aim of the article was to review studies on the tracking of physical activity in all phases of life from childhood to late adulthood. The majority of the studies have been published since 2000. The follow-up time in most studies was short, the median being 9 years. In men, the stability of physical activity was significant but low or moderate during all life phases and also in longterm follow-ups. In women, the tracking was lower and in many cases non-significant. Among both sexes, stability seems to be lower in early childhood than in adolescence or in adulthood and lower in transitional phases, such as from childhood to adolescence or from adolescence to adulthood, than in adulthood. However, the differences in the stability of physical activity between age groups and between different phases of life were small. The number of tracking studies utilising objective methods to measure physical activity was so small that systematic differences in stability between self-report and objective methods could not be determined. A factor which caused differences in tracking results was the adjustment of correlations for measurement error and other error variance. Adjusted coefficients were clearly higher than unadjusted ones. However, adjustment was done only in very few studies. If the different methods used for estimating habitual physical activity and the failure to control for important covariates in studies of tracking are taken into account, physical activity appears to track reasonably well also in the longer term, for example from adolescence to adulthood. The results of the tracking studies support the idea that the enhancement of physical activity in children and adolescents is of great importance for the promotion of public health.
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              Socioeconomic factors, health behaviors, and mortality: results from a nationally representative prospective study of US adults.

              A prominent hypothesis regarding social inequalities in mortality is that the elevated risk among the socioeconomically disadvantaged is largely due to the higher prevalence of health risk behaviors among those with lower levels of education and income. To investigate the degree to which 4 behavioral risk factors (cigarette smoking, alcohol drinking, sedentary lifestyle, and relative body weight) explain the observed association between socioeconomic characteristics and all-cause mortality. Longitudinal survey study investigating the impact of education, income, and health behaviors on the risk of dying within the next 7.5 years. A nationally representative sample of 3617 adult women and men participating in the Americans' Changing Lives survey. All-cause mortality verified through the National Death Index and death certificate reviews. Educational differences in mortality were explained in full by the strong association between education and income. Controlling for age, sex, race, urbanicity, and education, the hazard rate ratio of mortality was 3.22 (95% confidence interval [CI], 2.01-5.16) for those in the lowest-income group and 2.34 (95% CI, 1.49-3.67) for those in the middle-income group. When health risk behaviors were considered, the risk of dying was still significantly elevated for the lowest-income group (hazard rate ratio, 2.77; 95% CI, 1.74-4.42) and the middle-income group (hazard rate ratio, 2.14; 95% CI, 1.38-3.25). Although reducing the prevalence of health risk behaviors in low-income populations is an important public health goal, socioeconomic differences in mortality are due to a wider array of factors and, therefore, would persist even with improved health behaviors among the disadvantaged.
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                Author and article information

                Contributors
                Role: Formal analysisRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
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                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: VisualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: Writing – review & editing
                Role: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
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                Role: ConceptualizationRole: Writing – review & editing
                Role: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curation
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
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                Role: ConceptualizationRole: Funding acquisitionRole: Writing – review & editing
                Role: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                19 January 2018
                2018
                : 13
                : 1
                : e0190737
                Affiliations
                [1 ] School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland
                [2 ] School of Health and Human Performance, Dublin City University, Dublin, Ireland
                [3 ] Section of Hygiene—Institute of Public Health; Università Cattolica del Sacro Cuore, L.go F. Vito, Rome, Italy
                [4 ] Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
                [5 ] Dept of Sport, Leisure and Childhood Studies, Cork Institute of Technology, Cork, Ireland
                [6 ] Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
                [7 ] Department of Physical Education and Sports Sciences, University of Limerick, Limerick, Ireland
                [8 ] Council for Agricultural Research and Economics -Research Centre for Food and Nutrition, Rome, Italy
                [9 ] Department of Movement, Human and Health Sciences, University of Rome Foro Italico, P.za Lauro de Bosis, Rome, Italy
                [10 ] Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
                [11 ] Department of Medicine and Aging Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti and Pescara, Italy
                [12 ] Department for Sport and Exercise Sciences, University of Stuttgart, Stuttgart, Germany
                [13 ] Department of Epidemiology and Prevention. IRCCS Instituto Neurologico Mediterraneo: NEUROMED. Pozzilli, Italy
                [14 ] Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
                [15 ] Department of Sports Science, University of Konstanz, Konstanz, Germany
                [16 ] Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
                [17 ] CarMeN Laboratory, INSERM U1060, Lyon 1 University, CRNH-Rhône-Alpes, CENS, Lyon, France
                University of Lausanne Hospital Centre, SWITZERLAND
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0001-7636-9312
                Article
                PONE-D-17-27929
                10.1371/journal.pone.0190737
                5774703
                29351286
                37133bb3-8a6e-4ae1-b91c-0dbd6af176e2
                © 2018 O’Donoghue et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 28 July 2017
                : 14 December 2017
                Page count
                Figures: 1, Tables: 7, Pages: 24
                Funding
                Funded by: Italian Ministry of Instruction, University and Research
                Award ID: DEDIPAC F.S. 02.15.02 COD.B84G14000040008 /CDR2.PRIN 2010/11 COD. 2010KL2Y73_003
                Funded by: funder-id http://dx.doi.org/10.13039/501100002347, Bundesministerium für Bildung und Forschung;
                Award ID: 01EA1377; 01EA1374; 01EA1372C; 01EA1372E
                Funded by: funder-id http://dx.doi.org/10.13039/100010414, Health Research Board;
                Award ID: DEDIPAC/2013/1
                Funded by: funder-id http://dx.doi.org/10.13039/501100005401, Ministero delle Politiche Agricole Alimentari e Forestali;
                Award ID: DEDIPAC-IRILD, D.M.14474/7303/13
                Funded by: funder-id http://dx.doi.org/10.13039/501100006488, Institut National de la Recherche Agronomique;
                Funded by: funder-id http://dx.doi.org/10.13039/100010102, Institut National de Prévention et d'Éducation pour la Santé;
                Funded by: funder-id http://dx.doi.org/10.13039/501100003130, Fonds Wetenschappelijk Onderzoek;
                This work is supported by the following funding bodies: MIUR (Italian Ministry of Instruction, University and Research): DEDIPAC F.S.; 02.15.02 COD. B84G14000040008 – AP, KA, GC, CC, ADB, PI, GN, AS, SB, LC and CDR2.PRIN 2010/11 COD. 2010KL2Y73_003 – LI, GC; and Research Foundation Flanders Belgium – GC, MDC, SDH; and Ministry of Agricultural, Food and Forestry Policies (Ministero delle Politiche Agricole Alimentari e Forestali) Italy (DEDIPAC-IRILD, D.M., 14474/7303/13) – AP, CD; and Health Research Board Ireland; DEDIPAC/2013/1- GOD, AK, CB, AC, TC, JI, FL, CMD, RS; and Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung, Förderkennzeichen Germany; 01EA1377, 01EA1374, 01EA1372C, 01EA1372E – CB, SH, LJ, MK, AL, TP, HS, WS, AS; and Institut National de la Recherche Agronomique (INRA) and Institut National de Prévention et d’Education pour la Sante (INPES) France: CS, JAN, CP.
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