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      Ten-Year Changes in the Prevalence and Socio-Demographic Determinants of Physical Activity among Polish Adults Aged 20 to 74 Years. Results of the National Multicenter Health Surveys WOBASZ (2003-2005) and WOBASZ II (2013-2014)

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          Abstract

          Introduction

          The aim of the study was to estimate ten-year changes in physical activity (PA) patterns and sociodemographic determinants among adult residents of Poland.

          Methods

          The study comprised two independent samples of randomly selected adults aged 20–74 years participating in the National Multicentre Health Survey WOBASZ (2003–2005; n = 14572) and WOBASZ II (2013–2014; n = 5694). In both surveys the measurements were performed by six academic centers in all 16 voivodships of Poland (108 measurement points in each survey). Sociodemographic data were collected by an interviewer-administered questionnaire in both surveys. Physical activity was assessed in three domains: leisure-time, occupational and commuting physical activity.

          Results

          Leisure-time PA changed substantially between the surveys (p<0.001). The prevalence of subjects being active on most days of week fell in both genders in the years 2003–2014 (37.4% vs 27.3% in men); 32.7% vs 28.3% in women. None or occasional activity increased from 49.6% to 56.8% in men, while remained stable in women (55.2% vs 54.9%). In both WOBASZ surveys the likelihood of physical inactivity was higher in less educated individuals, smokers and those living in large agglomerations (p<0.01). No significant changes were observed in occupational activity in men between the surveys, while in women percentage of sedentary work increased from 43.4% to % 49.4% (p<0.01). Commuting PA decreased significantly in both genders (p<0.001). About 79.3% of men and 71.3% of women reported no active commuting in the WOBASZ II survey.

          Conclusions

          The observed unfavourable changes in PA emphasize the need for novel intervention concepts in order to reverse this direction. Further detailed monitoring of PA patterns in Poland is of particular importance.

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          Most cited references21

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          Dose response between physical activity and risk of coronary heart disease: a meta-analysis.

          No reviews have quantified the specific amounts of physical activity required for lower risks of coronary heart disease when assessing the dose-response relation. Instead, previous reviews have used qualitative estimates such as low, moderate, and high physical activity. We performed an aggregate data meta-analysis of epidemiological studies investigating physical activity and primary prevention of CHD. We included prospective cohort studies published in English since 1995. After reviewing 3194 abstracts, we included 33 studies. We used random-effects generalized least squares spline models for trend estimation to derive pooled dose-response estimates. Among the 33 studies, 9 allowed quantitative estimates of leisure-time physical activity. Individuals who engaged in the equivalent of 150 min/wk of moderate-intensity leisure-time physical activity (minimum amount, 2008 U.S. federal guidelines) had a 14% lower coronary heart disease risk (relative risk, 0.86; 95% confidence interval, 0.77 to 0.96) compared with those reporting no leisure-time physical activity. Those engaging in the equivalent of 300 min/wk of moderate-intensity leisure-time physical activity (2008 U.S. federal guidelines for additional benefits) had a 20% (relative risk, 0.80; 95% confidence interval, 0.74 to 0.88) lower risk. At higher levels of physical activity, relative risks were modestly lower. People who were physically active at levels lower than the minimum recommended amount also had significantly lower risk of coronary heart disease. There was a significant interaction by sex (P=0.03); the association was stronger among women than men. These findings provide quantitative data supporting US physical activity guidelines that stipulate that "some physical activity is better than none" and "additional benefits occur with more physical activity."
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            Active commuting and cardiovascular risk: a meta-analytic review.

            Leisure time physical activity is inversely associated with cardiovascular risk, although evidence for the protective effects of active commuting is more limited. The present review examines evidence from prospective epidemiological studies of commuting activity and cardiovascular risk. Meta-analytic procedures were performed to examine the association between commuting physical activity and cardiovascular risk. Several cardiovascular endpoints were examined including mortality, incident coronary heart disease, stroke, hypertension and diabetes. We included eight studies in the overall analysis (173,146 participants) that yielded 15 separate risk ratios (RR). The overall meta-analysis demonstrated a robust protective effect of active commuting on cardiovascular outcomes (integrated RR=0.89, 95% confidence interval 0.81-0.98, p=0.016). However, the protective effects of active commuting were more robust among women (0.87, 0.77-0.98, p=0.02) than in men (0.91, 0.80-1.04, p=0.17). Active commuting that incorporates walking and cycling was associated with an overall 11% reduction in cardiovascular risk, which was more robust among women. Future studies should investigate the reasons for possible gender effects and also examine the importance of commuting activity intensity.
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              Temporal trends in physical activity: a systematic review.

              In spite of all accumulated scientific knowledge on the benefits of physical activity (PA) for health, high rates of sedentary lifestyle are still observed worldwide. The aim of this study was to systematically review articles on temporal trends of PA and fitness, with emphasis on differences between children/ adolescents and adults. An electronic search at the Medline/PubMed database was carried out using the following combination of keywords: temporal trends or trends or surveillance or monitoring and PA or exercise or physical fitness or motor activity or sedentary or fitness. By using this strategy, 23,088 manuscripts were detected. After examination, 41 articles fulfilled all inclusion criteria, and were, therefore, included. The data currently available in the literature for adults shows that leisure-time activity levels tend to be increasing over time, while occupational-related PA is decreasing over time. Youth PA seems to be decreasing over time, including a lower level of activity in physical education classes. As a consequence, fitness levels are also declining. PA surveillance must be strongly encouraged in all settings and age groups. Special attention must be paid to low and middle-income countries, where PA surveillance is virtually inexistent.
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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, CA USA )
                1932-6203
                7 June 2016
                2016
                : 11
                : 6
                : e0156766
                Affiliations
                [1 ]Department of Preventive Medicine, Medical University of Lodz, Lodz, Poland
                [2 ]Department of Epidemiology and Biostatistics, Medical University of Lodz, Lodz, Poland
                [3 ]Department of Social Pathologies, Medical University of Lodz, Lodz, Poland
                [4 ]Department and Clinic of Cardiology, Medical University of Silesia, Katowice, Poland
                [5 ]Department of Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University of Krakow, Krakow, Poland
                [6 ]Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Cardinal Stefan Wyszynski University, Institute of Cardiology, Warsaw, Poland
                [7 ]Department and Clinic of Hipertensiology Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
                [8 ]Department and Clinic of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
                University of Bologna, ITALY
                Author notes

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

                Conceived and designed the experiments: WD WB KK AP AT TZ. Performed the experiments: ER. Analyzed the data: MK MP EDZ WB WD KK AP AT JP TZ. Contributed reagents/materials/analysis tools: WD. Wrote the paper: MK MP WB WD.

                Article
                PONE-D-16-02342
                10.1371/journal.pone.0156766
                4896475
                27272130
                f16faae0-453c-4fed-84e7-c5650abf4841
                © 2016 Kwaśniewska 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
                : 21 January 2016
                : 19 May 2016
                Page count
                Figures: 3, Tables: 2, Pages: 14
                Funding
                The WOBASZ II Project was financed from the resources at the disposal of the Minister of Health within the framework of the “National Program of Equalization and Accessibility to Cardiovascular Disease Prevention and Treatment for 2010-2012 POLKARD – goal: Analyses and epidemiology – “Monitoring of the epidemiological situation in Poland in the field of cardiovascular diseases.”
                Categories
                Research Article
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                People and Places
                Geographical Locations
                Europe
                Poland
                People and Places
                Population Groupings
                Age Groups
                Adults
                Research and Analysis Methods
                Research Design
                Survey Research
                Surveys
                Engineering and Technology
                Transportation
                Social Sciences
                Sociology
                Education
                Educational Attainment
                Biology and Life Sciences
                Biomechanics
                Biological Locomotion
                Walking
                Biology and Life Sciences
                Physiology
                Biological Locomotion
                Walking
                Medicine and Health Sciences
                Physiology
                Biological Locomotion
                Walking
                Medicine and Health Sciences
                Health Care
                Health Risk Analysis
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

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