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      Objective vs. Self-Reported Physical Activity and Sedentary Time: Effects of Measurement Method on Relationships with Risk Biomarkers

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          Abstract

          Purpose

          Imprecise measurement of physical activity variables might attenuate estimates of the beneficial effects of activity on health-related outcomes. We aimed to compare the cardiometabolic risk factor dose-response relationships for physical activity and sedentary behaviour between accelerometer- and questionnaire-based activity measures.

          Methods

          Physical activity and sedentary behaviour were assessed in 317 adults by 7-day accelerometry and International Physical Activity Questionnaire (IPAQ). Fasting blood was taken to determine insulin, glucose, triglyceride and total, LDL and HDL cholesterol concentrations and homeostasis model-estimated insulin resistance (HOMA IR). Waist circumference, BMI, body fat percentage and blood pressure were also measured.

          Results

          For both accelerometer-derived sedentary time (<100 counts.min −1) and IPAQ-reported sitting time significant positive (negative for HDL cholesterol) relationships were observed with all measured risk factors – i.e. increased sedentary behaviour was associated with increased risk (all p≤0.01). However, for HOMA IR and insulin the regression coefficients were >50% lower for the IPAQ-reported compared to the accelerometer-derived measure ( p<0.0001 for both interactions). The relationships for moderate-to-vigorous physical activity (MVPA) and risk factors were less strong than those observed for sedentary behaviours, but significant negative relationships were observed for both accelerometer and IPAQ MVPA measures with glucose, and insulin and HOMA IR values (all p<0.05). For accelerometer-derived MVPA only, additional negative relationships were seen with triglyceride, total cholesterol and LDL cholesterol concentrations, BMI, waist circumference and percentage body fat, and a positive relationship was evident with HDL cholesterol ( p = 0.0002). Regression coefficients for HOMA IR, insulin and triglyceride were 43–50% lower for the IPAQ-reported compared to the accelerometer-derived MVPA measure (all p≤0.01).

          Conclusion

          Using the IPAQ to determine sitting time and MVPA reveals some, but not all, relationships between these activity measures and metabolic and vascular disease risk factors. Using this self-report method to quantify activity can therefore underestimate the strength of some relationships with risk factors.

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          Most cited references26

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          Calibration of the Computer Science and Applications, Inc. accelerometer.

          We established accelerometer count ranges for the Computer Science and Applications, Inc. (CSA) activity monitor corresponding to commonly employed MET categories. Data were obtained from 50 adults (25 males, 25 females) during treadmill exercise at three different speeds (4.8, 6.4, and 9.7 km x h(-1)). Activity counts and steady-state oxygen consumption were highly correlated (r = 0.88), and count ranges corresponding to light, moderate, hard, and very hard intensity levels were or = 9499 cnts x min(-1), respectively. A model to predict energy expenditure from activity counts and body mass was developed using data from a random sample of 35 subjects (r2 = 0.82, SEE = 1.40 kcal x min(-1)). Cross validation with data from the remaining 15 subjects revealed no significant differences between actual and predicted energy expenditure at any treadmill speed (SEE = 0.50-1.40 kcal x min(-1)). These data provide a template on which patterns of activity can be classified into intensity levels using the CSA accelerometer.
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            Measuring agreement in method comparison studies.

            Agreement between two methods of clinical measurement can be quantified using the differences between observations made using the two methods on the same subjects. The 95% limits of agreement, estimated by mean difference +/- 1.96 standard deviation of the differences, provide an interval within which 95% of differences between measurements by the two methods are expected to lie. We describe how graphical methods can be used to investigate the assumptions of the method and we also give confidence intervals. We extend the basic approach to data where there is a relationship between difference and magnitude, both with a simple logarithmic transformation approach and a new, more general, regression approach. We discuss the importance of the repeatability of each method separately and compare an estimate of this to the limits of agreement. We extend the limits of agreement approach to data with repeated measurements, proposing new estimates for equal numbers of replicates by each method on each subject, for unequal numbers of replicates, and for replicated data collected in pairs, where the underlying value of the quantity being measured is changing. Finally, we describe a nonparametric approach to comparing methods.
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              Limits to the measurement of habitual physical activity by questionnaires.

              Despite extensive use over 40 years, physical activity questionnaires still show limited reliability and validity. Measurements have value in indicating conditions where an increase in physical activity would be beneficial and in monitoring changes in population activity. However, attempts at detailed interpretation in terms of exercise dosage and the extent of resulting health benefits seem premature. Such usage may become possible through the development of standardised instruments that will record the low intensity activities typical of sedentary societies, and will ascribe consistent biological meaning to terms such as light, moderate, and heavy exercise.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2012
                9 May 2012
                : 7
                : 5
                : e36345
                Affiliations
                [1 ]Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
                [2 ]School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
                [3 ]Laboratory of Nutritional Genomics, Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
                [4 ]Center of Nutrition, Metabolism and Physical Activity (CNEF), Concepción, Chile
                [5 ]Department of Physical Education, University of Concepción, Concepción, Chile
                McGill University, Canada
                Author notes

                Conceived and designed the experiments: CACM FPB MESB JMRG. Performed the experiments: CACM FPB LI CS. Analyzed the data: CACM MESB JMRG. Wrote the paper: CACM MESB JMRG.

                Article
                PONE-D-12-06438
                10.1371/journal.pone.0036345
                3348936
                22590532
                dac45a7a-92e4-40fa-a574-cbeaf7b2527e
                Celis-Morales 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
                : 3 March 2012
                : 5 April 2012
                Page count
                Pages: 10
                Categories
                Research Article
                Medicine
                Cardiovascular
                Diagnostic Medicine
                Pathology
                General Pathology
                Biomarkers
                Epidemiology
                Biomarker Epidemiology
                Epidemiological Methods
                Nutrition
                Obesity
                Public Health
                Behavioral and Social Aspects of Health
                Preventive Medicine
                Sports and Exercise Medicine

                Uncategorized
                Uncategorized

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