Physical activity, exercise and self-rated health: a population-based study from Sweden
Marita Sdergren
0
Jan Sundquist
0
Sven-Erik Johansson
0
Kristina Sundquist
0
0
Address: Center for Family and Community Medicine, Karolinska Institute
,
Stockholm
,
Sweden
Background: In order to screen for the most inactive individuals in the population and target health-related interventions where they are most needed it is important to assess different forms of physical activity in population-based studies. The aims were (1) to identify the most inactive individuals in the population by assessing two dimensions of physical activity, (2) to investigate the correlation between exercise and total physical activity and (3) to investigate the association between exercise, total physical activity and good self-rated health. Methods: A simple random sample of the Swedish population aged 25-64 years were interviewed about their living conditions, health and lifestyle in a survey performed by Statitics Sweden. In total 1876 women and 1880 men completed the survey during 1999 (response rate 76.6%) when two different questions about physical activity assessed exercise and total physical activity in all domains (e.g. transportation, exercise, and at work). Logistic regression models were used to estimate odds ratios. Results: The most inactive individuals (no exercise and total physical activity 2 hours per week) constituted 4.3% of the sample. The correlation between exercise and total physical activity was low (gamma = 0.4, p = 0.02). There were significant associations between higher levels of exercise, total physical activity and good self-rated health after adjustment for age, gender, country of birth, education, employment, marital status, housing tenure, smoking and BMI. Conclusion: Both exercise and total physical activity were independently associated with good self-rated health. It seems to be advantageous to use more than one question in population based surveys in order to evaluate several dimensions of physical activity and identify the most inactive individuals.
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Background
Physical activity has a documented positive effect on a
number of health outcomes [1-7]. For example, physical
activity can prevent diabetes mellitus and cardiovascular
disease [1,4,6,7] and reduce mortality [5,8,9]. Previous
research has also documented an association between
physical activity and self-rated health[10,11]. Although
self-rated health could be regarded as a subjective
measure, it is a powerful predictor of morbidity and mortality
[12-15]. It can also be used for cross-cultural comparisons
[16].
Physical activity is often measured as physical activity
during leisure-time, i.e. exercise.
Exercise is defined as "a specific type of physical activity
that is planned, structured and repeatedly done to
improve or maintain physical fitness, whereas the
definition of physical activity is "any bodily movement
produced by skeletal muscles that result in energy
expenditure" [17]. The positive effects of physical activity
can be gained in different ways and do not necessarily
include exercise. An important limitation in studies where
only exercise has been assessed is that physical activities in
other domains have not been taken into account. In order
to obtain a better understanding of physical activity
patterns among individuals and populations it is therefore
important to assess the total amount of physical activity or
physical activity obtained in all domains, including
exercise, physical activity at work, physical activity during
transportation and household-related activities. This is
particularly important in order to screen for the most
inactive individuals so that health-related interventions can be
targeted where they are most needed[18]. Previous studies
suggest that the largest health benefits of increasing the
level of physical activity can be expected among those that
are most inactive [19-21].
The first aim of the present study was to identify the most
inactive individuals in the population by assessing two
dimensions of physical activity: exercise and total physical
activity. The second aim was to investigate the correlation
between exercise and total physical activity. The third aim
was to investigate the association between self-rated
health and the two assessments of physical activity after
adjustment for the independent variables age, gender,
country of birth, education, employment, marital status,
housing tenure and the lifestyle factors smoking and body
mass index (BMI).
Methods
Statistics Sweden (the Swedish government-owned
statistics bureau) has performed an annual survey of the adult
Swedish population since 1975. Participants are
interviewed face-to-face by trained interviewers about their
living conditions, including questions about health and
health-related conditions, welfare and lifestyle. The
participants in the present study were part of that survey and
consisted of a simple random sample representative of the
Swedish population aged 2564 years in 1999. Only
participants from the year 1 (...truncated)